Provider Demographics
NPI:1629175278
Name:MEINCKE-WOHLERS, LYNN ANN (LISW)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ANN
Last Name:MEINCKE-WOHLERS
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 1:704 S MISSISSIPPI ST
Mailing Address - Street 2:
Mailing Address - City:BLUE GRASS
Mailing Address - State:IA
Mailing Address - Zip Code:52726-9547
Mailing Address - Country:US
Mailing Address - Phone:563-381-4508
Mailing Address - Fax:
Practice Address - Street 1:2800 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2012
Practice Address - Country:US
Practice Address - Phone:563-445-0557
Practice Address - Fax:563-445-1604
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00869104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker