MEDICARE: YOHANA TECLEAB

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
1	101Y00000X	Counselor	92841	TX

General Provider Information

NPI Number	:	1053291559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOHANA TECLEAB

Provider Business Mailing Address
First Line	:	3418 N TARRANT PKWY STE 320
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76177-8646
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3418 N TARRANT PKWY STE 320
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76177-8646
Country	:	US
Telephone Number	:	682-432-1571
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	09/04/2025

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Directions to “ YOHANA TECLEAB ” Practice Location

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