Individual
NICOLE R WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1031 OFFICE PARK RD STE 6, WEST DES MOINES, IA 50265-2582
(515) 304-5475
Mailing address
1706 SYCAMORE ST, DALLAS CENTER, IA 50063-1033
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
130436
IA
Other
Enumeration date
01/14/2026
Last updated
01/14/2026
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