| Doctor Name: | KELLY SUE VAN GELDER |
| NPI Number: | 1356518518 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW |
| License Number: | 03604 |
| Business Practice Address: | 1905 10th St Rock Valley, IA - 512471630 |
| Business Phone Number: | 7124765245 |
| Business Fax Number: | 7124769621 |
| Mailing Address: | Po Box 163, ROCK VALLEY |
| State: | IA |
| Postal Code: | 512470163 |
| Phone Number: | 7124765245 |
| Fax Number: | 7124769621 |
| NPI Enumeration Date: | 05/15/2008 |
| NPI Last Update Date: | 05/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 03604 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |