Provider Demographics
NPI:1023400223
Name:DRIER, WILLIAM (PHD; LISW)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:DRIER
Suffix:
Gender:M
Credentials:PHD; LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 WESTCHESTER RD APT H
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-4500
Mailing Address - Country:US
Mailing Address - Phone:312-720-7267
Mailing Address - Fax:
Practice Address - Street 1:3356 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5700
Practice Address - Country:US
Practice Address - Phone:319-214-2159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-24
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.015.162104100000X
IA077437104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker