Provider Demographics
NPI:1295453389
Name:COCHENOUR, TARYN
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:COCHENOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:
Other - Last Name:BENNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:TAMA
Mailing Address - State:IA
Mailing Address - Zip Code:52339-2520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 4TH AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-1844
Practice Address - Country:US
Practice Address - Phone:319-364-1953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA114071101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health