Healthcare Provider Details

I. General information

NPI: 1336812916
Provider Name (Legal Business Name): KALYN ABIGAIL HARDIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7308 ALMA DR
PLANO TX
75025-3568
US

IV. Provider business mailing address

7308 ALMA DR
PLANO TX
75025-3568
US

V. Phone/Fax

Practice location:
  • Phone: 972-422-5939
  • Fax:
Mailing address:
  • Phone: 972-422-5939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number83015
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: