MEDICARE: MRS. CARIN YATES MS

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	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1679562193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARIN YATES MS

Provider Business Mailing Address
First Line	:	170 GROSSE PINES DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-1832
Country	:	US
Telephone Number	:	312-485-1013
Fax Number	:

Provider Business Practice Location Address
First Line	:	3031 W GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-3046
Country	:	US
Telephone Number	:	313-916-7958
Fax Number	:	313-916-1730

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	03/03/2015

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