MEDICARE: CAYLEE YANES OT

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
1	225X00000X	Occupational Therapist	16808	NC

General Provider Information

NPI Number	:	1497587182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAYLEE YANES OT

Provider Business Mailing Address
First Line	:	1100 BLYTHE BLVD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5814
Country	:	US
Telephone Number	:	704-355-7760
Fax Number	:

Provider Business Practice Location Address
First Line	:	5350 PINEHURST PARK DR APT 1019
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-4934
Country	:	US
Telephone Number	:	678-920-9800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2024
Last Update Date	:	08/20/2024

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