Provider Demographics
NPI:1295939577
Name:STRATHDEE, DENISE DONNA (RD,LD, LMHC)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:DONNA
Last Name:STRATHDEE
Suffix:
Gender:F
Credentials:RD,LD, LMHC
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Mailing Address - Street 1:1227 E. RUSHOLME STREET
Mailing Address - Street 2:SUITE 101, MEDICAL OFFICE BUILDING 2
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-2459
Mailing Address - Country:US
Mailing Address - Phone:563-421-8361
Mailing Address - Fax:563-421-8369
Practice Address - Street 1:1227 EAST RUSHOLME STREET
Practice Address - Street 2:SUITE 101, MEDICAL OFFICE BUILDING 2
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2459
Practice Address - Country:US
Practice Address - Phone:563-421-8361
Practice Address - Fax:563-421-8369
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA00763101YM0800X
IA00290133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health