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General NPI Number Information
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NPI Number | 1225810344
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Entity Type | Organization
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Legal Business Name | I AM YANA MO
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 370 E 160TH ST
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City | BRONX
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State | NY
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Zip | 10451-4404
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Country | US
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Telephone | 478-262-9997
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 CORPORATE POINTE STE 309
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City | WARNER ROBINS
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State | GA
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Zip | 31088-3441
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Country | US
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Telephone | 478-262-9997
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KEAYANA NICOLA MINUS
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Credential | LMHC
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Telephone | 478-262-9997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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