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Individual

TARA LEA RATHJEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2501 S CENTER STREET, SUITE M, MARSHALLTOWN, IA 50158
(319) 361-6529
Mailing address
PO BOX 4, VAN HORNE, IA 52346-0004
(319) 361-6529
(319) 298-0970

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0101342
IA
Enumeration date
09/06/2013
Last updated
09/17/2013
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