Basic Information
| Provider Information | |||||||||
| NPI: | 1003002114 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATSCHKE | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | JEAN | ||||||||
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| Credential: | ISW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 337 | ||||||||
| Address2: | |||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 524060337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193697091 | ||||||||
| FaxNumber: | 3193697071 | ||||||||
| Practice Location | |||||||||
| Address1: | 855 A AVE NE | ||||||||
| Address2: | |||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 524025057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193697091 | ||||||||
| FaxNumber: | 3193697071 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2007 | ||||||||
| LastUpdateDate: | 11/27/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 00933 | IA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.