Provider Demographics
NPI:1760602197
Name:HUBER, ELIZABETH ANN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:HUBER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25863 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7313
Mailing Address - Country:US
Mailing Address - Phone:563-332-3485
Mailing Address - Fax:
Practice Address - Street 1:215 6TH AVE S
Practice Address - Street 2:SUITE #32
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-4338
Practice Address - Country:US
Practice Address - Phone:563-593-0630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health