Provider Demographics
NPI:1083812846
Name:HESS, MURIEL ANNE JACOBSON (LISW)
Entity Type:Individual
Prefix:MS
First Name:MURIEL
Middle Name:ANNE JACOBSON
Last Name:HESS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:MURIELLE
Other - Middle Name:ANNE JACOBSON
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:520 S PIERCE AVE
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2749
Mailing Address - Country:US
Mailing Address - Phone:641-421-8077
Mailing Address - Fax:641-494-5005
Practice Address - Street 1:520 S PIERCE AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2749
Practice Address - Country:US
Practice Address - Phone:641-421-8077
Practice Address - Fax:641-494-5005
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IALMSW 05000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker