Provider Demographics
NPI:1982397949
Name:MAGNOLIA CONNECTION, PC
Entity Type:Organization
Organization Name:MAGNOLIA CONNECTION, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PEDIATRIC PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SOYER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:515-994-8255
Mailing Address - Street 1:1819 MAGNOLIA CIR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-8405
Mailing Address - Country:US
Mailing Address - Phone:954-540-8908
Mailing Address - Fax:
Practice Address - Street 1:2251 SUNSET DR STE D
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-9114
Practice Address - Country:US
Practice Address - Phone:515-994-8255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty