Provider Demographics
NPI:1467899005
Name:DARDEN-JEFFERSON, MICHELLE RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:RENEE
Last Name:DARDEN-JEFFERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7810 SICKLE CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75241-5344
Mailing Address - Country:US
Mailing Address - Phone:972-998-5208
Mailing Address - Fax:
Practice Address - Street 1:281 N I 35 E
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-5299
Practice Address - Country:US
Practice Address - Phone:972-998-5208
Practice Address - Fax:469-297-5167
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor