Provider Demographics
NPI:1598892655
Name:YASHARIAN, DARLENE J (OTR)
Entity Type:Individual
Prefix:MISS
First Name:DARLENE
Middle Name:J
Last Name:YASHARIAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 DISCUS DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-7701
Mailing Address - Country:US
Mailing Address - Phone:347-617-9082
Mailing Address - Fax:
Practice Address - Street 1:7361 PRAIRIE FALCON RD
Practice Address - Street 2:SUITE #130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0823
Practice Address - Country:US
Practice Address - Phone:702-804-1511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9004225X00000X
NV085005225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist