Provider Demographics
NPI:1134517345
Name:LASANE, DARRELL A (BA)
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:A
Last Name:LASANE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:DARRELL
Other - Middle Name:A
Other - Last Name:DURDIN-STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2917 VIGILANTE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6401
Mailing Address - Country:US
Mailing Address - Phone:702-308-4364
Mailing Address - Fax:702-778-9232
Practice Address - Street 1:2917 VIGILANTE CT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-6401
Practice Address - Country:US
Practice Address - Phone:702-308-4364
Practice Address - Fax:702-778-9232
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-23
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor