Provider Demographics
NPI:1447226279
Name:DOYLE-ERRTHUM, KATHLEEN R (MSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:R
Last Name:DOYLE-ERRTHUM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-1690
Mailing Address - Country:US
Mailing Address - Phone:319-339-4757
Mailing Address - Fax:319-656-2085
Practice Address - Street 1:369 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1690
Practice Address - Country:US
Practice Address - Phone:319-339-4757
Practice Address - Fax:319-656-2085
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02806101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA19937OtherBLUE CROSS PROVIDER NUMBE