Provider Demographics
NPI:1205887882
Name:ESPE PFEIFER, PATRICIA BETH (PHD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:BETH
Last Name:ESPE PFEIFER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:BETH
Other - Last Name:ESPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-363-6314
Mailing Address - Fax:319-363-7788
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-363-6314
Practice Address - Fax:319-363-7788
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01002103T00000X
IA00470103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA10694OtherWELLMARK BCBS
IA0499582Medicaid
IA10694OtherWELLMARK BCBS
IA0499582Medicaid