Provider Demographics
NPI:1215025309
Name:GARRELTS-DAOUD, DEBORAH LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNNE
Last Name:GARRELTS-DAOUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LYNNE
Other - Last Name:GARRELTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3908 BEAVER RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-9400
Mailing Address - Country:US
Mailing Address - Phone:319-277-3004
Mailing Address - Fax:
Practice Address - Street 1:3251 W 9TH ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5310
Practice Address - Country:US
Practice Address - Phone:319-234-2893
Practice Address - Fax:319-234-0354
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1003702084P0800X
IA345692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0074435Medicaid
IA07443Medicare ID - Type Unspecified
IA0074435Medicaid
IAIB224Medicare PIN