Provider Demographics
NPI:1033158050
Name:YAFFE, DONNA MERLE
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MERLE
Last Name:YAFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8423 TALLY HO RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4725
Mailing Address - Country:US
Mailing Address - Phone:703-425-8269
Mailing Address - Fax:
Practice Address - Street 1:5610A SANDY LEWIS DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-4034
Practice Address - Country:US
Practice Address - Phone:800-688-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03471103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6100122OtherEVERCARE
MD60484701OtherBCBS MD
MDKN18743ZMedicare ID - Type Unspecified