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NPI Code Detail

MEDICARE: MRS. ELISA YOHO ED.S.

MEDICARE: MRS. ELISA YOHO ED.S.
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
1103TS0200XSchool Psychologist912FL

General Provider Information

NPI Number : 1821365891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELISA YOHO ED.S.
Provider Business Mailing Address
First Line : 3270 SUNTREE BLVD STE 202
Second Line :
City : MELBOURNE
State : FL
Zip : 32940-7540
Country : US
Telephone Number : 321-749-2549
Fax Number :
Provider Business Practice Location Address
First Line : 3270 SUNTREE BLVD STE 202
Second Line :
City : MELBOURNE
State : FL
Zip : 32940-7540
Country : US
Telephone Number : 321-749-2549
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2011
Last Update Date : 11/19/2011

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