Organization
QCCOUNSELOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK MICHAEL MARTENSON MS ED (THERAPIST/OWNER)
(563) 639-4359
Entity
Organization
Contact information
Practice address
2028 E 38TH ST, SUITE 3, DAVENPORT, IA 52807-1168
(563) 639-4359
Mailing address
2028 E 38TH ST, SUITE 3, DAVENPORT, IA 52807-1168
(563) 639-4359
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
00728
IA
Other
Enumeration date
07/28/2011
Last updated
07/28/2011
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