Provider Demographics
NPI:1093821738
Name:FOLTZ-DANIELS, KELLI ANN (LISW, CADC)
Entity type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:ANN
Last Name:FOLTZ-DANIELS
Suffix:
Gender:F
Credentials:LISW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-1548
Mailing Address - Country:US
Mailing Address - Phone:515-282-2200
Mailing Address - Fax:
Practice Address - Street 1:1800 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1548
Practice Address - Country:US
Practice Address - Phone:515-282-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06280104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker