Provider Demographics
NPI:1356747190
Name:JOSEPH, DASHA LEANN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DASHA
Middle Name:LEANN
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 CASTLE ST
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-5803
Mailing Address - Country:US
Mailing Address - Phone:405-326-2698
Mailing Address - Fax:
Practice Address - Street 1:7707 SAN JACINTO PL STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3215
Practice Address - Country:US
Practice Address - Phone:405-326-2698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126868363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health