Illuminate Life Therapy, LLC

NPI #1194408500 in Ankeny, Iowa

Provider Information

NPI Number: 1194408500
Entity Type: Organization
Organization Name: Illuminate Life Therapy, LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Aug 11, 2023
Last Updated: Aug 16, 2023

Practice Location

Address: 1605 N ANKENY BLVD STE 110
City: Ankeny
State: Iowa
ZIP Code: 50023-4163
Phone: (515) 520-8164

Authorized Official

Name: CAROLYN HOLLISTER, LISW
Title: OWNER
Phone: (515) 520-8164

Specialties & Taxonomy Codes

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

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