Provider Demographics
NPI:1093346959
Name:YARBROUGH, CARLA (MS)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:YARBROUGH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RIVER PLACE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-5402
Mailing Address - Country:US
Mailing Address - Phone:313-871-2337
Mailing Address - Fax:313-871-1805
Practice Address - Street 1:100 RIVER PLACE DR STE 250
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-5402
Practice Address - Country:US
Practice Address - Phone:313-871-2337
Practice Address - Fax:313-871-1805
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator