Individual
DR. CASEY L FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4455 E 56TH ST, DAVENPORT, IA 52807-2995
(954) 895-1519
Mailing address
4455 E 56TH ST, DAVENPORT, IA 52807-2995
(563) 355-2577
(563) 355-4015
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
091435
IA
103TC0700X
Clinical Psychologist
8818
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427464817
—
FL
Enumeration date
07/07/2014
Last updated
06/07/2019
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