Healthcare Provider Details

I. General information

NPI: 1710813399
Provider Name (Legal Business Name): LEAH ANN VANDE HOEF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 MAIN ST
HULL IA
51239-7712
US

IV. Provider business mailing address

2033 13TH ST
ROCK VALLEY IA
51247-1406
US

V. Phone/Fax

Practice location:
  • Phone: 712-463-3505
  • Fax:
Mailing address:
  • Phone: 712-463-3505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1013583
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: