Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003257544 |
---|---|
Provider Name | Ms. Kateri Lynn Nesbitt |
First Address | Davenport, IA 52806-5623 |
Second Address | Sterling, IL 61081-4151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2013 |
Last Update Date | 12/07/2013 |