Provider Demographics
NPI:1760790588
Name:HARDEN, JACINDA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:JACINDA
Middle Name:LYNN
Last Name:HARDEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:HARDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:107 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:KINDER
Mailing Address - State:LA
Mailing Address - Zip Code:70648-3512
Mailing Address - Country:US
Mailing Address - Phone:337-738-4118
Mailing Address - Fax:337-738-5604
Practice Address - Street 1:2314 W ADAMS AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-3937
Practice Address - Country:US
Practice Address - Phone:254-778-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor