Chance, Darissa D

Chance, Darissa D is an individual health care provider with primary practice located at 1527 Albia Rd , Ottumwa IA 52501-3907. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Chance, Darissa D can be contacted via phone (641) 682-8772.

Contact Information

Primary practice address
1527 Albia Rd Ottumwa IA 52501-3907
Phone: (641) 682-8772
Fax: (641) 682-1924
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 06258 Iowa

Profile Details

NPI number 1265425805
LBN Legal business name Chance, Darissa D
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated May 9th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265425805 NPPES
Iowa Other T016 TRIWEST
Iowa MEDICAID 0421537 TRIWEST
Iowa Other 221801 TRIWEST

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