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General NPI Number Information
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NPI Number | 1720134927
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Entity Type | Organization
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Legal Business Name | BEVERLY K. YAHNKE DBA CHRISTIAN COUNSELING SVCS
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Dates
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Enumeration Date | 01/28/2007
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 2600 N MAYFAIR RD SUITE 870
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City | WAUWATOSA
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State | WI
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Zip | 53226-1309
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Country | US
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Telephone | 414-774-6770
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 N MAYVAIR RD, PO BOX 26097 CHRISTIAN COUNSELING SERVICES SUITE 870
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City | WAUWATOSA
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State | WI
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Zip | 53226-1309
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Country | US
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Telephone | 414-774-6770
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Fax | 414-774-3299
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | DR. BEVERLY KAY YAHNKE
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Credential | PH.D.
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Telephone | 414-774-6770
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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 | 1395057
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License Number State | WI
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