Healthcare Provider Details

I. General information

NPI: 1184494494
Provider Name (Legal Business Name): MRS. KARENA LYNN SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 COIT RD STE B
PLANO TX
75075-3758
US

IV. Provider business mailing address

6649 BARCLAY LN
GARLAND TX
75044-3402
US

V. Phone/Fax

Practice location:
  • Phone: 972-596-7229
  • Fax:
Mailing address:
  • Phone: 214-715-0984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number93148
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: