Organization Name: | FAMILY COUNSELING & PSYCHOLOGY CENTER P.C. |
NPI Number: | 1083719587 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | COLLIN ANDREW LODICO (OWNER) |
Mailing Address: | 2485 Tech Dr Bettendorf |
State: | IA US |
Postal Code: | 527223262 |
Phone Number: | 5633551611 |
Fax Number: | 5633556617 |
NPI Enumeration Date: | 09/13/2006 |
NPI Last Update Date: | 06/22/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |