Provider Demographics
NPI:1982156634
Name:MONDRIANH-YBARRA, KARENA (PHD)
Entity Type:Individual
Prefix:
First Name:KARENA
Middle Name:
Last Name:MONDRIANH-YBARRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 OLD DENTON RD
Mailing Address - Street 2:SUITE 317
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007
Mailing Address - Country:US
Mailing Address - Phone:936-524-6902
Mailing Address - Fax:
Practice Address - Street 1:3044 OLD DENTON RD
Practice Address - Street 2:SUITE 317
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5016
Practice Address - Country:US
Practice Address - Phone:936-524-6902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist