Individual
KELLY MARSENGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4403 1ST AVE SE STE 104, CEDAR RAPIDS, IA 52402-3221
(319) 202-1509
Mailing address
4403 1ST AVE SE STE 104, CEDAR RAPIDS, IA 52402-3221
(319) 202-1509
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00026
IA
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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