Individual
NORA ELIZABETH WENZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 W 3RD ST, DAVENPORT, IA 52802-1344
(630) 779-6867
Mailing address
1202 W 3RD ST, DAVENPORT, IA 52802-1344
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104307
—
IA
Enumeration date
10/10/2018
Last updated
10/10/2018
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