Doctor Name: | DARLENE ELLA VANCHURA |
NPI Number: | 1003087131 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LPC |
License Number: | 15952 |
Business Practice Address: | 5751 Kroger Dr Suite 235 Keller, TX - 762485532 |
Business Phone Number: | 8173714312 |
Business Fax Number: | |
Mailing Address: | 4108 Dogwood Ln, FORT WORTH |
State: | TX |
Postal Code: | 761371716 |
Phone Number: | 8173714312 |
Fax Number: | |
NPI Enumeration Date: | 03/17/2008 |
NPI Last Update Date: | 03/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 15952 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |