Provider Demographics
NPI:1093588337
Name:YAGUDAYEVA, DORA
Entity Type:Individual
Prefix:
First Name:DORA
Middle Name:
Last Name:YAGUDAYEVA
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 1:4300 S MONACO ST APT 408
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3591
Mailing Address - Country:US
Mailing Address - Phone:909-377-7385
Mailing Address - Fax:
Practice Address - Street 1:4300 S MONACO ST APT 408
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-3591
Practice Address - Country:US
Practice Address - Phone:909-377-7385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst