Provider Demographics
NPI:1467270256
Name:WEINER, LINDY JANE-DOKKEN (MS)
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:JANE-DOKKEN
Last Name:WEINER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 BARDIN RD APT 709
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3869
Mailing Address - Country:US
Mailing Address - Phone:815-980-3639
Mailing Address - Fax:
Practice Address - Street 1:3033 BARDIN RD APT 709
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3869
Practice Address - Country:US
Practice Address - Phone:815-980-3639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92076101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor