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NPI Code Detail

MEDICARE: MRS. YALANDA GRIFFIN HENDERSON LCSW

MEDICARE: MRS. YALANDA GRIFFIN HENDERSON LCSW
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
11041C0700XClinical Social Worker36890TX

General Provider Information

NPI Number : 1902058134
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. YALANDA GRIFFIN HENDERSON LCSW
Provider Business Mailing Address
First Line : 1212 QUINCY DR
Second Line :
City : GLENN HEIGHTS
State : TX
Zip : 75154-8699
Country : US
Telephone Number : 972-533-1572
Fax Number : 972-533-1572
Provider Business Practice Location Address
First Line : 3803 BOULDER DR
Second Line :
City : DALLAS
State : TX
Zip : 75233-3114
Country : US
Telephone Number : 972-502-4020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2008
Last Update Date : 08/28/2024

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