Healthcare Provider Details

I. General information

NPI: 1689646762
Provider Name (Legal Business Name): SUSAN FRANCES YOCKEY LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 OHIO RIVER BLVD
BADEN PA
15005-1914
US

IV. Provider business mailing address

58 S FREMONT AVE #12
PITTSBURGH PA
15202-3746
US

V. Phone/Fax

Practice location:
  • Phone: 724-869-2222
  • Fax: 724-869-3155
Mailing address:
  • Phone: 412-855-3924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW004444E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: