Provider Demographics
NPI:1952517278
Name:WOZNIAK-REBHUHN, CAROL ANN (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:WOZNIAK-REBHUHN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 CATTAIL LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-9101
Mailing Address - Country:US
Mailing Address - Phone:319-364-0612
Mailing Address - Fax:
Practice Address - Street 1:1403 CATTAIL LN
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-9101
Practice Address - Country:US
Practice Address - Phone:319-364-0612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00043106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist