Basic Information
Provider Information
NPI: 1275547507
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DARIO
FirstName: JOEL
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 460
Address2:  
City: BOUNTIFUL
State: UT
PostalCode: 840110460
CountryCode: US
TelephoneNumber: 8012983446
FaxNumber:  
Practice Location
Address1: 2250 ROBINS DR
Address2:  
City: LAYTON
State: UT
PostalCode: 840411140
CountryCode: US
TelephoneNumber: 8017737060
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/29/2006
LastUpdateDate: 02/06/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X357684-4408UTY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


Home