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Individual

DR. AGNES WATERSTREET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D

Contact information

Practice address
1721 N FILLMORE ST, DAVENPORT, IA 52804-3724
(563) 324-7143
Mailing address
1721 N FILLMORE ST, DAVENPORT, IA 52804-3724

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
00070
IA

Other

Enumeration date
08/07/2008
Last updated
08/07/2008
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