Healthcare Provider Details

I. General information

NPI: 1205787942
Provider Name (Legal Business Name): MARCIA DAIGLE TLMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 UTICA RIDGE RD STE B
BETTENDORF IA
52722-1653
US

IV. Provider business mailing address

3625 UTICA RIDGE RD STE B
BETTENDORF IA
52722-1653
US

V. Phone/Fax

Practice location:
  • Phone: 563-279-4189
  • Fax:
Mailing address:
  • Phone: 563-279-4189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number136632
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: