Provider Demographics
NPI:1780692137
Name:SITKA, DARALEEN (OTR)
Entity type:Individual
Prefix:MRS
First Name:DARALEEN
Middle Name:
Last Name:SITKA
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:PSC 819
Mailing Address - Street 2:BOX 50
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09645-0050
Mailing Address - Country:ES
Mailing Address - Phone:3495-684-7390
Mailing Address - Fax:
Practice Address - Street 1:PSC 819
Practice Address - Street 2:BOX 50
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09645-0050
Practice Address - Country:ES
Practice Address - Phone:3495-684-7390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00445544171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider