Provider Demographics
NPI:1053683839
Name:YEE, JOE DAN (MHPP)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:DAN
Last Name:YEE
Suffix:
Gender:M
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71653-1941
Mailing Address - Country:US
Mailing Address - Phone:870-265-2186
Mailing Address - Fax:870-265-2305
Practice Address - Street 1:313 MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71653-1941
Practice Address - Country:US
Practice Address - Phone:870-265-2186
Practice Address - Fax:870-265-2305
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator