Provider Demographics
NPI:1992493951
Name:DONLON, KELLY
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:DONLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 34TH ST NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3532
Mailing Address - Country:US
Mailing Address - Phone:319-327-1014
Mailing Address - Fax:
Practice Address - Street 1:1450 BOYSON RD STE C1
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-2323
Practice Address - Country:US
Practice Address - Phone:319-382-8660
Practice Address - Fax:319-382-8693
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health