Provider Demographics
NPI:1467685016
Name:DEKKERS, TARA DANIELLE (PHD, LMFT)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:DANIELLE
Last Name:DEKKERS
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 WESTWINDS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-2752
Mailing Address - Country:US
Mailing Address - Phone:712-541-2659
Mailing Address - Fax:
Practice Address - Street 1:2205 E GRANTVIEW DR
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-3351
Practice Address - Country:US
Practice Address - Phone:712-541-2659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist