Doctor Name: | TARA LYNN BOER |
NPI Number: | 1851601322 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1419 1st St Hull, IA - 512397341 |
Business Phone Number: | 7128986468 |
Business Fax Number: | |
Mailing Address: | 315 1st Ave Ne, SIOUX CENTER |
State: | IA |
Postal Code: | 512501801 |
Phone Number: | 7127224900 |
Fax Number: | 7127224901 |
NPI Enumeration Date: | 10/18/2010 |
NPI Last Update Date: | 01/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |