Individual
RACHEL KELLENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 W 4TH ST, DAVENPORT, IA 52801-1104
(563) 328-4125
Mailing address
400 W 4TH ST, DAVENPORT, IA 52801-1104
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
IA
Enumeration date
01/23/2018
Last updated
02/07/2018
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