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PHILLIP L KENT PSY.D.

Clinical Neuropsychologist

Davenport, Iowa

Provider NPI: 1407844277

Provider Information:
 PHILLIP L KENT PSY.D.
Gender: M
Not Sole Proprietor

Practice Location:
4455 E 56TH ST  DAVENPORT, IA 52807 US
Tel: 563-355-2577  Fax: 563-355-4015

Business Mailing Address:
865 LINCOLN RD STE L10 BETTENDORF, IA 52722 US
Tel: 563-355-9191  Fax: 563-355-3419

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
IA00929
X103T00000XBehavioral Health & Social Service Providers
Psychologist
IA00424
X103T00000XBehavioral Health & Social Service Providers
Psychologist
IA00929
X103T00000XBehavioral Health & Social Service Providers
Psychologist
MNLP1079
X103T00000XBehavioral Health & Social Service Providers
Psychologist
IL

Other Provider Identifiers:

IssuerNumberStateType
0447185IA05
JOHN DEERE HEALTH PLANIA01C301
WELLMARK HEALTH PLAN45245IA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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