Provider Demographics
NPI:1124571153
Name:HAMBLIN, DAREN DWAYNE
Entity Type:Individual
Prefix:
First Name:DAREN
Middle Name:DWAYNE
Last Name:HAMBLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 MCCARRAN ST
Mailing Address - Street 2:2014
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-8135
Mailing Address - Country:US
Mailing Address - Phone:702-427-1792
Mailing Address - Fax:
Practice Address - Street 1:101 S RAINBOW BLVD
Practice Address - Street 2:1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5362
Practice Address - Country:US
Practice Address - Phone:702-778-8922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor