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General NPI Number Information
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NPI Number | 1528407665
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Entity Type | Individual
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Provider Name | KATIE YODER PSYD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 1750 SUN PEAK DR SUITE 175
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City | PARK CITY
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State | UT
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Zip | 84098-6724
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Country | US
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Telephone | 435-200-5525
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Fax |
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Provider Business Mailing Address
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Address Line | 8129 COURTYARD LOOP APT 9
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City | PARK CITY
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State | UT
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Zip | 84098-4770
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Country | US
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Telephone | 435-200-5525
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 8450689-2501
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License Number State | UT
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