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General NPI Number Information
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NPI Number | 1386471621
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Entity Type | Individual
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Provider Name | MARINA HENARY
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Gender | Female
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 6221 CHAPEL HILL BLVD STE 300
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City | PLANO
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State | TX
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Zip | 75093-4750
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Country | US
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Telephone | 469-409-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 1199 N BROADWAY ST APT 244
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City | CARROLLTON
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State | TX
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Zip | 75006-0015
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Country | US
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Telephone | 817-319-4947
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1175624
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License Number State | TX
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