Renewed Rebellion Wellness Company
Social Worker in Waterloo, IA. Organization (NPI-2).
NPI number1104776558
StatusActive
Last updated in NPPESFeb 3, 2026
Details
- NPI
- 1104776558
- Entity type
- Organization (NPI-2)
- Legal business name
- Renewed Rebellion Wellness Company
- Organization subpart
- No
- Enumeration date
- Feb 3, 2026
- Last updated
- Feb 3, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | – | – | Yes |
Practice location
531 Commercial St.#700
Waterloo, IA 50701
Phone 319-988-1413
Mailing address
531 Commercial St.#700
Waterloo, IA 50701
Phone 319-988-1413
Authorized official
Carly Lyn Heimerdinger
Lisw
3199881413
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