MEDICARE: DARRIAN RAQUEL SILVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1073042362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRIAN RAQUEL SILVA

Provider Business Mailing Address
First Line	:	6877 TAMARUS ST UNIT 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0395
Country	:	US
Telephone Number	:	702-475-2960
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 S RAINBOW BLVD STE 114
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-5343
Country	:	US
Telephone Number	:	702-754-5566
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	06/21/2017

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Directions to “ DARRIAN RAQUEL SILVA ” Practice Location

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