Provider Demographics
NPI:1427570084
Name:DAHLEM, DARAH LYNNE
Entity Type:Individual
Prefix:MISS
First Name:DARAH
Middle Name:LYNNE
Last Name:DAHLEM
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 1:401 E FRONT ST STE 123
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-8250
Mailing Address - Country:US
Mailing Address - Phone:903-531-2581
Mailing Address - Fax:903-531-2451
Practice Address - Street 1:401 E. FRONT STREET STE 123
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703
Practice Address - Country:US
Practice Address - Phone:903-531-2581
Practice Address - Fax:903-531-2451
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107560235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist