MEDICARE: HYEYOON NIKI JOO

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1861200479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYEYOON NIKI JOO

Provider Business Mailing Address
First Line	:	8233 SOUTHWESTERN BLVD APT 1036
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-2153
Country	:	US
Telephone Number	:	972-533-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	8233 SOUTHWESTERN BLVD APT 1036
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-2153
Country	:	US
Telephone Number	:	972-533-1300
Fax Number	:

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

Provider Enumeration Date	:	12/28/2024
Last Update Date	:	12/28/2024

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Directions to “ HYEYOON NIKI JOO ” Practice Location

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