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General NPI Number Information
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NPI Number | 1356888259
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Entity Type | Individual
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Provider Name | DARA D'ELIA
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Gender | Female
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 1452 AMBROSIA ST
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City | BEAUMONT
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State | CA
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Zip | 92223-8473
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Country | US
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Telephone | 909-519-9825
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Fax |
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Provider Business Mailing Address
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Address Line | 22711 ETON DR
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City | GRAND TERRACE
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State | CA
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Zip | 92313-5136
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Country | US
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Telephone | 909-797-0114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCC7949
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License Number State | CA
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