Healthcare Provider Details

I. General information

NPI: 1356855902
Provider Name (Legal Business Name): KATREEN YARBOROUGH ED.S, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATREEN SIDHOM

II. Dates (important events)

Enumeration Date: 11/18/2017
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 THORNCRAG LN
MIDLOTHIAN VA
23112-4561
US

IV. Provider business mailing address

2201 THORNCRAG LN
MIDLOTHIAN VA
23112-4561
US

V. Phone/Fax

Practice location:
  • Phone: 443-452-8571
  • Fax: 443-452-8571
Mailing address:
  • Phone: 443-452-8571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPPS-0601637
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: