Individual
VIVIAN NENION DOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 NW WILLIAMSBURG LN, WAUKEE, IA 50263
(712) 843-4074
Mailing address
1201 NW WILLIAMBURG LANE, WAUKEE, IA 50263
(712) 843-4074
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
IA
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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