Basic Information
| Provider Information | |||||||||
| NPI: | 1295352680 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEVLIN-LAWLER | ||||||||
| FirstName: | TARAH | ||||||||
| MiddleName: | CHEYENNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 HIGHWAY 59 | ||||||||
| Address2: | |||||||||
| City: | DEFIANCE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 515277110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7208793394 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1213 GARFIELD AVE | ||||||||
| Address2: | |||||||||
| City: | HARLAN | ||||||||
| State: | IA | ||||||||
| PostalCode: | 515372057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7127555056 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2020 | ||||||||
| LastUpdateDate: | 07/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 101265 | IA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.