Provider Demographics
NPI:1699420893
Name:CANTER, DARLENA RENEE
Entity type:Individual
Prefix:
First Name:DARLENA
Middle Name:RENEE
Last Name:CANTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 ALTIZER AVE TRLR 28
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-1999
Mailing Address - Country:US
Mailing Address - Phone:304-955-8532
Mailing Address - Fax:
Practice Address - Street 1:5400 ALTIZER AVE TRLR 28
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-1999
Practice Address - Country:US
Practice Address - Phone:304-955-8532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant