Provider Demographics
NPI:1689110280
Name:PAPROCK, DARA
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:
Last Name:PAPROCK
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 1:2245 LILLIE AVE UNIT 564
Mailing Address - Street 2:
Mailing Address - City:SUMMERLAND
Mailing Address - State:CA
Mailing Address - Zip Code:93067-7035
Mailing Address - Country:US
Mailing Address - Phone:512-484-8958
Mailing Address - Fax:
Practice Address - Street 1:2245 LILLIE AVE UNIT 564
Practice Address - Street 2:
Practice Address - City:SUMMERLAND
Practice Address - State:CA
Practice Address - Zip Code:93067-7035
Practice Address - Country:US
Practice Address - Phone:512-484-8958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24555101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)