Provider Demographics
NPI:1407952971
Name:DREW, JANET MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:MARIE
Last Name:DREW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-4201
Mailing Address - Country:US
Mailing Address - Phone:563-242-5316
Mailing Address - Fax:563-242-3128
Practice Address - Street 1:215 6TH AVE S
Practice Address - Street 2:STE 25
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-4338
Practice Address - Country:US
Practice Address - Phone:563-242-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00804103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA06865OtherBLUE CROSS/BLUE SHIELD
IAI12000Medicare ID - Type Unspecified
IA183494Medicaid