Individual
KASSIDY LYN SUITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A CADC
Contact information
Practice address
1523 S FAIRMOUNT ST, DAVENPORT, IA 52802-3644
(563) 322-2667
(563) 322-3671
Mailing address
1523 S FAIRMOUNT ST, DAVENPORT, IA 52802-3621
(563) 322-2667
(563) 322-3671
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25029
IOWA BOARD OF CERTIFICATIONS
IA
Enumeration date
02/14/2024
Last updated
03/11/2025
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