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NPI Code Detail

MEDICARE: DR. TARA M DOWNIE PSY.D.

MEDICARE: DR. TARA M DOWNIE PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist01879MO

General Provider Information

NPI Number : 1932359189
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TARA M DOWNIE PSY.D.
Provider Business Mailing Address
First Line : 2864 S NETTLETON AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-5970
Country : US
Telephone Number : 417-605-7100
Fax Number : 417-708-0889
Provider Business Practice Location Address
First Line : 2864 S NETTLETON AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-5970
Country : US
Telephone Number : 417-605-7100
Fax Number : 417-708-0889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2008
Last Update Date : 04/13/2026

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