Individual
JENNY RIEHL-DITSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1523 S FAIRMOUNT ST, DAVENPORT, IA 52802-3644
(563) 322-2667
Mailing address
1523 S FAIRMOUNT ST, DAVENPORT, IA 52802-3644
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
IA
Enumeration date
01/17/2018
Last updated
02/07/2018
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