Healthcare Provider Details

I. General information

NPI: 1235058868
Provider Name (Legal Business Name): KATY DELAGARDELLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3356 KIMBALL AVE STE 11
WATERLOO IA
50702-5700
US

IV. Provider business mailing address

3356 KIMBALL AVE STE 11
WATERLOO IA
50702-5700
US

V. Phone/Fax

Practice location:
  • Phone: 319-239-1699
  • Fax:
Mailing address:
  • Phone: 319-239-1699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN DELAGARDELLE
Title or Position: OWNER
Credential: LISW
Phone: 319-239-1699