Provider Demographics
NPI:1386430684
Name:DOAN, VI
Entity type:Individual
Prefix:
First Name:VI
Middle Name:
Last Name:DOAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8191 E RIVER RD APT 3
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-1775
Mailing Address - Country:US
Mailing Address - Phone:612-501-7205
Mailing Address - Fax:
Practice Address - Street 1:8060 STATE HIGHWAY 55 STE 100
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MN
Practice Address - Zip Code:55373-9407
Practice Address - Country:US
Practice Address - Phone:612-930-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN306981101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)