Provider Demographics
NPI:1073042362
Name:SILVA, DARRIAN RAQUEL
Entity Type:Individual
Prefix:
First Name:DARRIAN
Middle Name:RAQUEL
Last Name:SILVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6877 TAMARUS ST UNIT 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0395
Mailing Address - Country:US
Mailing Address - Phone:702-475-2960
Mailing Address - Fax:
Practice Address - Street 1:222 S RAINBOW BLVD STE 114
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5343
Practice Address - Country:US
Practice Address - Phone:702-754-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling