Most Relevant Information
Provider Data
| NPI Number: | 1003644543 |
| Provider Name: | NICOLE STANDAERT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/25/2024 |
| Last Updated: | 07/25/2024 |
Provider Practice Location
2240 9TH ST
CORALVILLE
IA
522411575
Practice Location Phone/Fax
| Phone: | 5154508913 |
| Fax: |
Provider Mailing Location
2240 9TH ST
CORALVILLE
IA
522411575
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |