Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 15952 | TX |
NPI | 1003087131 |
---|---|
Provider Name | Darlene Ella Vanchura |
First Address | Fort Worth, TX 76137-1716 |
Second Address | Keller, TX 76248-5532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2008 |
Last Update Date | 17/03/2008 |