Healthcare Provider Details

I. General information

NPI: 1255760500
Provider Name (Legal Business Name): DARIA SIRIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 09/28/2024
Certification Date: 09/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 W OBERLIN WAY
PHOENIX AZ
85085-4788
US

IV. Provider business mailing address

44047 N 43RD AVE
PHOENIX AZ
85087-6100
US

V. Phone/Fax

Practice location:
  • Phone: 914-610-1684
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number16746
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: