MEDICARE: YASHIRA MCCRAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	225XP0019X	Physical Rehabilitation Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	261QX0100X	Occupational Medicine Clinic/Center	AZ
4	261QH0700X	Hearing and Speech Clinic/Center
5	373H00000X	Day Training/Habilitation Specialist
6	385H00000X	Respite Care
7	225100000X	Physical Therapist
8	225X00000X	Occupational Therapist
9	171400000X	Health & Wellness Coach

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	825324248	OTHER	AZ	HOME COMMUNITY BASED SERVICES

General Provider Information

NPI Number	:	1942957527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASHIRA MCCRAY

Provider Business Mailing Address
First Line	:	188 E JEFFERSON ST APT 701
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2899
Country	:	US
Telephone Number	:	602-600-8748
Fax Number	:

Provider Business Practice Location Address
First Line	:	6917 S 11TH DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-6743
Country	:	US
Telephone Number	:	602-600-8748
Fax Number	:

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

Provider Enumeration Date	:	03/03/2022
Last Update Date	:	11/17/2023

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Directions to “ YASHIRA MCCRAY ” Practice Location

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