Provider Demographics
NPI:1447368857
Name:WENDELL-MOJICA, NADINE ESTHER (LMFT)
Entity type:Individual
Prefix:MRS
First Name:NADINE
Middle Name:ESTHER
Last Name:WENDELL-MOJICA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NADINE
Other - Middle Name:
Other - Last Name:PATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:312 EAST COLLEGE STREET
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240
Mailing Address - Country:US
Mailing Address - Phone:319-339-8231
Mailing Address - Fax:319-358-2323
Practice Address - Street 1:312 EAST COLLEGE STREET
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240
Practice Address - Country:US
Practice Address - Phone:319-339-8231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC23385106H00000X
IA00063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
245655OtherMIDLANDS CHOICE