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General NPI Number Information
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NPI Number | 1568353092
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Entity Type | Individual
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Provider Name | KINERET YARDENA
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Gender | Female
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Dates
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Enumeration Date | 07/12/2025
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Last Update Date | 07/12/2025
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Provider Practice Location Address
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Address Line | 10300 N CENTRAL EXPY
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City | DALLAS
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State | TX
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Zip | 75231-8600
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Country | US
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Telephone | 214-430-4476
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Fax |
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Provider Business Mailing Address
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Address Line | 9715 CLOISTER DR
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City | DALLAS
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State | TX
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Zip | 75228-3614
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 113766
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License Number State | TX
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