Provider Demographics
NPI:1053551754
Name:BUSCH, JANE KATHERINE (LISW, IAADC)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:KATHERINE
Last Name:BUSCH
Suffix:
Gender:F
Credentials:LISW, IAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 1ST AVE E
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-3127
Mailing Address - Country:US
Mailing Address - Phone:641-676-3720
Mailing Address - Fax:
Practice Address - Street 1:108 1ST AVE E
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-3127
Practice Address - Country:US
Practice Address - Phone:641-676-3720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA039051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical