Provider Demographics
NPI:1477958932
Name:ENGRAV, DEANNA (MFT)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:
Last Name:ENGRAV
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 NW 142ND STREET
Mailing Address - Street 2:202
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323
Mailing Address - Country:US
Mailing Address - Phone:319-573-6461
Mailing Address - Fax:515-224-3949
Practice Address - Street 1:3737 WOODLAND AVE
Practice Address - Street 2:STE.415
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1909
Practice Address - Country:US
Practice Address - Phone:515-222-1999
Practice Address - Fax:515-224-3949
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA075515106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist