MEDICARE: YORLAN PSYCHOLOGICAL ASSOCIATES, LLC

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	103TC0700X	Clinical Psychologist	PS017112	PA

General Provider Information

NPI Number	:	1790050185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YORLAN PSYCHOLOGICAL ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	3601 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-8741
Country	:	US
Telephone Number	:	717-885-0503
Fax Number	:	717-650-1281

Provider Business Practice Location Address
First Line	:	3601 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-8741
Country	:	US
Telephone Number	:	717-885-0503
Fax Number	:	717-650-1281

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SABRA N ABBOUD
Credential	:	PSY.D.
Telephone Number	:	717-885-0503

Provider Enumeration Date	:	03/19/2012
Last Update Date	:	01/02/2018

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