Provider Demographics
NPI:1114541794
Name:YEARBY, LETITIA AMARIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LETITIA
Middle Name:AMARIS
Last Name:YEARBY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12907 E JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48215-2751
Mailing Address - Country:US
Mailing Address - Phone:313-926-8918
Mailing Address - Fax:
Practice Address - Street 1:12907 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48215-2751
Practice Address - Country:US
Practice Address - Phone:313-926-8918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-30
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302046632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist