MEDICARE: YVONNE M WARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1518056837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE M WARD

Provider Business Mailing Address
First Line	:	6330 BIG OAK LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-2423
Country	:	US
Telephone Number	:	704-651-6094
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 J N PEASE PL
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4544
Country	:	US
Telephone Number	:	704-651-6094
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

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