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NPI Code Detail

MEDICARE: TIMOTHY YODER

MEDICARE: TIMOTHY YODER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.184660OH

General Provider Information

NPI Number : 1396449443
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY YODER
Provider Business Mailing Address
First Line : 212 W HIGH ST
Second Line :
City : MOUNT GILEAD
State : OH
Zip : 43338-1243
Country : US
Telephone Number : 419-889-1928
Fax Number :
Provider Business Practice Location Address
First Line : 18051 JEFFERSON PARK RD STE 106
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-3460
Country : US
Telephone Number : 419-889-1928
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2023
Last Update Date : 07/06/2023

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Directions to “ TIMOTHY YODER ” Practice Location

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