Healthcare Provider Details

I. General information

NPI: 1487076121
Provider Name (Legal Business Name): BLAKE YOHE MS, MADM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1195 ROOSEVELT AVE
YORK PA
17404-2350
US

IV. Provider business mailing address

625 W ELM AVE
HANOVER PA
17331-5125
US

V. Phone/Fax

Practice location:
  • Phone: 717-843-0800
  • Fax:
Mailing address:
  • Phone: 717-632-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: