Healthcare Provider Details
I. General information
NPI: 1932447547
Provider Name (Legal Business Name): KARI SUE YEARDLEY M.ED QBHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/17/2013
Last Update Date: 01/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
285 BIELBY RD
LAWRENCEBURG IN
47025-1055
US
IV. Provider business mailing address
285 BIELBY RD
LAWRENCEBURG IN
47025-1055
US
V. Phone/Fax
- Phone: 812-537-0194
- Fax: 812-370-0194
- Phone: 812-537-0194
- Fax: 812-370-0194
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: