Provider Demographics
NPI:1962390328
Name:MIAK, GATWECH RUACH
Entity type:Individual
Prefix:
First Name:GATWECH
Middle Name:RUACH
Last Name:MIAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 SADLER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-8047
Mailing Address - Country:US
Mailing Address - Phone:319-471-6685
Mailing Address - Fax:
Practice Address - Street 1:1251 334TH ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:IA
Practice Address - Zip Code:50276-7509
Practice Address - Country:US
Practice Address - Phone:515-438-3448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA118240103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst