Provider Demographics
NPI:1801207832
Name:HOSEK, DEANNE
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:
Last Name:HOSEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 8TH AVE W
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:IA
Mailing Address - Zip Code:52136-1064
Mailing Address - Country:US
Mailing Address - Phone:563-547-2022
Mailing Address - Fax:563-547-4340
Practice Address - Street 1:321 8TH AVE W
Practice Address - Street 2:
Practice Address - City:CRESCO
Practice Address - State:IA
Practice Address - Zip Code:52136-1064
Practice Address - Country:US
Practice Address - Phone:563-547-2022
Practice Address - Fax:563-547-4340
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA073009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health