Individual
KELLY WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
505 5TH ST STE 100, SIOUX CITY, IA 51101-1510
(712) 253-7100
Mailing address
505 5TH ST STE 100, SIOUX CITY, IA 51101-1510
(712) 253-7100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24065
IA
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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