MEDICARE: DR. YOLANDA TEREHAUN GARMON PSY.D.

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	6109	OH

General Provider Information

NPI Number	:	1962435289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOLANDA TEREHAUN GARMON PSY.D.

Provider Business Mailing Address
First Line	:	211 S MAIN ST STE 1130
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-2419
Country	:	US
Telephone Number	:	937-272-3267
Fax Number	:	937-223-3026

Provider Business Practice Location Address
First Line	:	211 S MAIN ST STE 1130
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-2419
Country	:	US
Telephone Number	:	937-272-3267
Fax Number	:	937-223-3026

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	07/08/2007

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