Provider Demographics
NPI:1477684082
Name:WARNER, DARLENE L (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:L
Last Name:WARNER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 UPTOWN BLVD STE 2000
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3528
Mailing Address - Country:US
Mailing Address - Phone:469-523-1365
Mailing Address - Fax:469-523-1366
Practice Address - Street 1:610 UPTOWN BLVD
Practice Address - Street 2:SUITE 2000
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3527
Practice Address - Country:US
Practice Address - Phone:469-523-1365
Practice Address - Fax:469-523-1366
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100989235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182122501Medicaid