Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 23402 | TX |
Y | 103T00000X | Psychologist | 23402 | TX |
NPI | 1013015833 |
---|---|
Provider Name | Ms. Stephanie Darsa |
First Address | Arlington, TX 76013-2537 |
Second Address | Arlington, TX 76013-2537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 05/04/2012 |