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General NPI Number Information
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NPI Number | 1770042921
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Entity Type | Organization
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Legal Business Name | YVONNE MAKIDON PLLC
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 8240 EMBURY RD STE A
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City | GRAND BLANC
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State | MI
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Zip | 48439-7113
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Country | US
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Telephone | 810-659-7242
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Fax |
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Provider Business Mailing Address
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Address Line | 3176 PERRY CT
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City | GRAND BLANC
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State | MI
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Zip | 48439-8151
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Country | US
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Telephone | 810-659-7242
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | DR. YVONNE PEARL MAKIDON
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Credential | PH.D., LMSW, LMFT
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Telephone | 810-659-7242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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