Provider Demographics
NPI:1932464534
Name:STALNAKER, DARLA L (M ED, LPC)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:L
Last Name:STALNAKER
Suffix:
Gender:F
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CARY PL
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-8510
Mailing Address - Country:US
Mailing Address - Phone:918-616-2701
Mailing Address - Fax:
Practice Address - Street 1:1305 S COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-7802
Practice Address - Country:US
Practice Address - Phone:919-686-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3120101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor