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NPI Code Detail

MEDICARE: JENNIFER HARDAWAY

MEDICARE:   JENNIFER  HARDAWAY
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
1101YP2500XProfessional Counselor90116TX

General Provider Information

NPI Number : 1417781436
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER HARDAWAY
Provider Business Mailing Address
First Line : 4601 66TH ST STE E
Second Line :
City : LUBBOCK
State : TX
Zip : 79414-4875
Country : US
Telephone Number : 806-630-0126
Fax Number : 806-722-5225
Provider Business Practice Location Address
First Line : 2100 VALLEY VIEW LN STE 400
Second Line :
City : FARMERS BRANCH
State : TX
Zip : 75234-1271
Country : US
Telephone Number : 469-546-7746
Fax Number : 806-722-5225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2024
Last Update Date : 01/12/2026

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Directions to “ JENNIFER HARDAWAY ” Practice Location

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