=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417016262
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DONNA NASSOIY DARLING LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4 HUBBLE ST
-----------------------------------------------------
City | PULASKI
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13142-4101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-298-5402
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 122
-----------------------------------------------------
City | PULASKI
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13142-0122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-396-7169
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 000131
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------