Provider Demographics
NPI:1689043986
Name:YATES, DARLA RENAE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:RENAE
Last Name:YATES
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7524 BOSQUE BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3772
Mailing Address - Country:US
Mailing Address - Phone:979-248-1370
Mailing Address - Fax:
Practice Address - Street 1:7524 BOSQUE BLVD STE D
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3772
Practice Address - Country:US
Practice Address - Phone:979-248-1370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71097101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional