Provider Demographics
NPI:1003238031
Name:YONTZ-HALL, CRISTIE L (PCC)
Entity Type:Individual
Prefix:MRS
First Name:CRISTIE
Middle Name:L
Last Name:YONTZ-HALL
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 PATRICK AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-2302
Mailing Address - Country:US
Mailing Address - Phone:937-484-6157
Mailing Address - Fax:
Practice Address - Street 1:204 PATRICK AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-2302
Practice Address - Country:US
Practice Address - Phone:937-484-6157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0700289101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional