Individual
KATHLEEN ELIZABETH SUDDARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, MT-BC
Contact information
Practice address
1501 42ND ST STE 445, WEST DES MOINES, IA 50266-1005
(630) 777-1265
Mailing address
1501 42ND ST STE 445, WEST DES MOINES, IA 50266-1005
(630) 777-1265
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
124501
IA
225A00000X
Music Therapist
08517
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08517
CERTIFICATION BOARD OF MUSIC THERAPISTS
—
Enumeration date
08/04/2008
Last updated
05/20/2024
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