Individual
MR. DARRELL T HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
500 N. INDIANA AVENUE, WINSLOW, AZ 86047-1269
(928) 289-4646
(928) 289-6225
Mailing address
500 N. INDIANA AVE., WINSLOW, AZ 86047-1269
(928) 289-4646
(928) 289-6225
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0132471
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0132471
LADAC
NM
Enumeration date
06/11/2010
Last updated
06/11/2010
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