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NPI Code Detail

MEDICARE: ALLISON YOUDERIAN

MEDICARE: ALLISON YOUDERIAN
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
1101Y00000XCounselor89311TX

General Provider Information

NPI Number : 1770329880
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON YOUDERIAN
Provider Business Mailing Address
First Line : 1300 ALTO VISTA ST
Second Line :
City : FAIRVIEW
State : TX
Zip : 75069-9773
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3900 S STONEBRIDGE DR STE 604
Second Line :
City : MCKINNEY
State : TX
Zip : 75070-8051
Country : US
Telephone Number : 469-946-8255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2024
Last Update Date : 07/08/2024

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