Provider Demographics
NPI:1114122959
Name:YATTA, BILLIE (DPT)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:
Last Name:YATTA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BILLIE
Other - Middle Name:
Other - Last Name:SHEETS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:606 E PITT ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-9723
Mailing Address - Country:US
Mailing Address - Phone:814-623-1436
Mailing Address - Fax:814-623-1921
Practice Address - Street 1:606 E PITT ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-9723
Practice Address - Country:US
Practice Address - Phone:814-623-1436
Practice Address - Fax:814-623-1921
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018750225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
19510030005OtherMEDICAL ASSISTANCE
PA102086947Medicaid
PA1975704OtherHIGHMARK
PA113228RASMedicare PIN