Provider Demographics
NPI:1477008613
Name:STRUVVE, TAMERA (CADC)
Entity Type:Individual
Prefix:
First Name:TAMERA
Middle Name:
Last Name:STRUVVE
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3232 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51103-3204
Mailing Address - Country:US
Mailing Address - Phone:712-202-0954
Mailing Address - Fax:712-224-3092
Practice Address - Street 1:3232 W 4TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51103-3204
Practice Address - Country:US
Practice Address - Phone:712-202-0954
Practice Address - Fax:712-224-3092
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16104101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)