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Individual

VICKI LYNN VANDERKWAAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
6200 AURORA AVE, STE 302W, URBANDALE, IA 50322-2800
(515) 331-0303
(515) 331-9086
Mailing address
2611 WASHINGTON STREET, PELLA, IA 50219
(641) 628-9599
(641) 621-1493

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0136879
IA
Enumeration date
06/27/2006
Last updated
07/08/2007
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