Provider Demographics
NPI:1366880965
Name:SQUIRES, DARLENE JEANNETTE
Entity type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:JEANNETTE
Last Name:SQUIRES
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DARLENE
Other - Middle Name:JEANNETTE
Other - Last Name:CORRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13967 E OXFORD PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-5137
Mailing Address - Country:US
Mailing Address - Phone:520-440-1017
Mailing Address - Fax:
Practice Address - Street 1:13967 E OXFORD PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5137
Practice Address - Country:US
Practice Address - Phone:520-440-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health