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General NPI Number Information
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NPI Number | 1285315911
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Entity Type | Individual
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Provider Name | BRANDI YACKEE
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Gender | Female
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 437 LAFAYETTE RD STE 200
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City | MEDINA
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State | OH
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Zip | 44256-2398
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Country | US
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Telephone | 216-672-8673
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Fax |
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Provider Business Mailing Address
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Address Line | 6241 ZEHMAN CT
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City | BROOKPARK
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State | OH
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Zip | 44142-1430
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Country | US
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Telephone | 216-672-8673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.1801492
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License Number State | OH
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