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General NPI Number Information
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NPI Number | 1760207005
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Entity Type | Organization
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Legal Business Name | DARREN JILEK PHD LICENSED PSYCHOLOGIST
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 634 S ROOSEVELT ST STE 4
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City | ABERDEEN
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State | SD
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Zip | 57401-6593
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Country | US
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Telephone | 605-228-4877
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Fax | 605-305-3604
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Provider Business Mailing Address
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Address Line | 39218 PRAIRIE RD
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City | MELLETTE
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State | SD
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Zip | 57461-5206
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARREN MICHAEL JILEK
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Credential | PHD
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Telephone | 605-228-4877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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