Individual
KIM VANDEVOORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
928 MAIN ST, KEOKUK, IA 52632-4655
(319) 524-4397
Mailing address
928 MAIN ST, KEOKUK, IA 52632-4655
(319) 524-4397
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
97109
IA
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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