MEDICARE: SIMONE YEOMANS M.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
1	106H00000X	Marriage & Family Therapist	35001700A	IN

General Provider Information

NPI Number	:	1841518800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONE YEOMANS M.S.

Provider Business Mailing Address
First Line	:	2512 COVINGTON ST
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-1404
Country	:	US
Telephone Number	:	765-497-3932
Fax Number	:	765-807-0225

Provider Business Practice Location Address
First Line	:	2512 COVINGTON ST
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-1404
Country	:	US
Telephone Number	:	765-497-3932
Fax Number	:	765-807-0225

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

Provider Enumeration Date	:	05/13/2010
Last Update Date	:	05/13/2010

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Directions to “ SIMONE YEOMANS M.S.” Practice Location

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