House, Darrell T

House, Darrell T is an individual health care provider with primary practice located at 500 N. Indiana Avenue , Winslow AZ 86047-1269. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. House, Darrell T can be contacted via phone (928) 289-4646.

Contact Information

Primary practice address
500 N. Indiana Avenue Winslow AZ 86047-1269
Fax: (928) 289-6225
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0132471 New Mexico

Profile Details

NPI number 1396065488
LBN Legal business name House, Darrell T
Credentials LADAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2010
Last updated Jun 11th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396065488 NPPES
New Mexico Other 0132471 LADAC

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