Provider Demographics
NPI:1083752828
Name:TONKYN, DIANE LYNN (ATR AND MFT)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:LYNN
Last Name:TONKYN
Suffix:
Gender:F
Credentials:ATR AND MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-4524
Mailing Address - Country:US
Mailing Address - Phone:319-339-0575
Mailing Address - Fax:
Practice Address - Street 1:123 N LINN ST
Practice Address - Street 2:SUITE 2D
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2143
Practice Address - Country:US
Practice Address - Phone:319-337-9461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00040106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist