Provider Demographics
NPI:1013884501
Name:CLOUGHER, KELLY MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:MARIE
Last Name:CLOUGHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 MERF
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-2600
Mailing Address - Country:US
Mailing Address - Phone:319-335-8056
Mailing Address - Fax:
Practice Address - Street 1:2213 2ND ST
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-1205
Practice Address - Country:US
Practice Address - Phone:319-358-2406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001362103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling