Provider Demographics
NPI:1033582317
Name:YASON, HERO (OTR)
Entity Type:Individual
Prefix:
First Name:HERO
Middle Name:
Last Name:YASON
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 CHRISTOPHER ST
Mailing Address - Street 2:APARTMENT 56
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-3500
Mailing Address - Country:US
Mailing Address - Phone:256-553-1414
Mailing Address - Fax:
Practice Address - Street 1:8612 US HIGHWAY 431
Practice Address - Street 2:SUITE 1
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0153
Practice Address - Country:US
Practice Address - Phone:256-878-1113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3706225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist