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General NPI Number Information
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NPI Number | 1316371487
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Entity Type | Individual
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Provider Name | BRANDON ANDREW YABKO PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/26/2013
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 2681 E PARLEYS WAY STE 203
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-1630
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Country | US
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Telephone | 385-355-1018
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Fax |
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Provider Business Mailing Address
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Address Line | 2681 E PARLEYS WAY STE 203
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-1630
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Country | US
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Telephone | 661-312-9335
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 8819350-2501
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License Number State | UT
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