Emerald Bridges Family Therapy, LLC

NPI #1073966123 in Independence, Iowa

Provider Information

NPI Number: 1073966123
Entity Type: Organization
Organization Name: Emerald Bridges Family Therapy, LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Jul 13, 2016
Last Updated: Jul 13, 2016

Practice Location

Address: 2349 JAMESTOWN AVE
Address 2: SUITE 5
City: Independence
State: Iowa
ZIP Code: 50644-9709
Phone: (563) 579-1181

Authorized Official

Name: TARA NISSEN, LISW
Title: MENTAL HEALTH THERAPIST
Phone: (563) 579-1181

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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