Provider Demographics
NPI:1467453407
Name:VASKE, CYNTHIA A (LISW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:A
Last Name:VASKE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1077 N CENTER POINT RD
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-1231
Mailing Address - Country:US
Mailing Address - Phone:319-369-8762
Mailing Address - Fax:319-368-5643
Practice Address - Street 1:1077 N CENTER POINT RD
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1231
Practice Address - Country:US
Practice Address - Phone:319-369-8762
Practice Address - Fax:319-368-5643
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA010451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA37435OtherBCBS