Healthcare Provider Details

I. General information

NPI: 1407412208
Provider Name (Legal Business Name): DARIO DAVID SILVA PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 MORNINGSIDE DR NE
ALBUQUERQUE NM
87110-6170
US

IV. Provider business mailing address

1235 MORNINGSIDE DR NE
ALBUQUERQUE NM
87110-6170
US

V. Phone/Fax

Practice location:
  • Phone: 575-640-8147
  • Fax:
Mailing address:
  • Phone: 575-640-8147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0124
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: