Individual
KELLY A. BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.S.W.
Contact information
Practice address
1811 PINEACRE AVE, DAVENPORT, IA 52803-3555
(563) 528-9191
Mailing address
1811 PINEACRE AVE, DAVENPORT, IA 52803-3555
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
077404
IA
Other
Enumeration date
12/24/2021
Last updated
12/24/2021
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