Provider Demographics
NPI:1114672276
Name:JONDAL, DAYNA YVONNE (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:YVONNE
Last Name:JONDAL
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N BISHOP AVE APT 469
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-1361
Mailing Address - Country:US
Mailing Address - Phone:507-440-3127
Mailing Address - Fax:
Practice Address - Street 1:200 N BISHOP AVE APT 469
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-1361
Practice Address - Country:US
Practice Address - Phone:507-440-3127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
735439295