Provider Demographics
NPI:1497734198
Name:GIOVANAZZI, ANN (LMHC CRC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:GIOVANAZZI
Suffix:
Gender:F
Credentials:LMHC CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-2271
Mailing Address - Country:US
Mailing Address - Phone:563-264-2222
Mailing Address - Fax:563-264-8076
Practice Address - Street 1:2925 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-2271
Practice Address - Country:US
Practice Address - Phone:563-264-2222
Practice Address - Fax:563-264-8076
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA886101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA247397OtherMIDLAND'S CHOICE