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NPI Code Detail

MEDICARE: KENDRA ELAINE DAILEY LPC

MEDICARE:   KENDRA ELAINE DAILEY  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor81391TX

General Provider Information

NPI Number : 1720684962
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRA ELAINE DAILEY LPC
Provider Business Mailing Address
First Line : 435 S ALEXANDER AVE
Second Line :
City : DUNCANVILLE
State : TX
Zip : 75116-4903
Country : US
Telephone Number : 972-372-4236
Fax Number :
Provider Business Practice Location Address
First Line : 2150 LAKESIDE BLVD STE 100
Second Line :
City : RICHARDSON
State : TX
Zip : 75082-4467
Country : US
Telephone Number : 972-437-4698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2020
Last Update Date : 12/10/2020

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Directions to “ KENDRA ELAINE DAILEY LPC” Practice Location

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