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:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
X | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | IA | 00929 |
X | 103T00000X | Behavioral Health & Social Service Providers Psychologist | MN | LP1079 |
X | 103T00000X | Behavioral Health & Social Service Providers Psychologist | IA | 00929 |
X | 103T00000X | Behavioral Health & Social Service Providers Psychologist | IA | 00424 |
X | 103T00000X | Behavioral Health & Social Service Providers Psychologist | IL |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
JOHN DEERE HEALTH PLAN | IA01C3 | 01 | |
0447185 | IA | 05 | |
WELLMARK HEALTH PLAN | 45245 | IA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin