| Doctor Name: | KELLY DARST |
| NPI Number: | 1225369747 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BHRS |
| License Number: | |
| Business Practice Address: | 1501 S Virginia Ave Atoka, OK - 745253233 |
| Business Phone Number: | 5803261663 |
| Business Fax Number: | |
| Mailing Address: | Rr 1 Box 7804, ANTLERS |
| State: | OK |
| Postal Code: | 745239747 |
| Phone Number: | 5803261663 |
| Fax Number: | |
| NPI Enumeration Date: | 01/22/2010 |
| NPI Last Update Date: | 01/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |