Provider Demographics
NPI:1205026812
Name:DE HAAN, DARLA JOY (MA)
Entity Type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:JOY
Last Name:DE HAAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-1918
Mailing Address - Country:US
Mailing Address - Phone:641-628-1723
Mailing Address - Fax:641-628-1723
Practice Address - Street 1:315 MAIN ST
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1918
Practice Address - Country:US
Practice Address - Phone:641-628-1723
Practice Address - Fax:641-628-1723
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00099106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist