Provider Demographics
NPI:1932719465
Name:STIGALL, DARLEISHA RENEE
Entity type:Individual
Prefix:
First Name:DARLEISHA
Middle Name:RENEE
Last Name:STIGALL
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 1:455 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-7118
Mailing Address - Country:US
Mailing Address - Phone:480-942-6019
Mailing Address - Fax:
Practice Address - Street 1:455 E 6TH ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-7118
Practice Address - Country:US
Practice Address - Phone:480-942-6019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARBACB618619106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician