Provider Demographics
NPI:1154791267
Name:ADELANA, YEWANDE
Entity type:Individual
Prefix:
First Name:YEWANDE
Middle Name:
Last Name:ADELANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-1717
Mailing Address - Country:US
Mailing Address - Phone:817-983-8120
Mailing Address - Fax:
Practice Address - Street 1:8915 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-1717
Practice Address - Country:US
Practice Address - Phone:817-983-8120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2019-01-30
Deactivation Date:2017-09-15
Deactivation Code:
Reactivation Date:2019-01-30
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker