Provider Demographics
NPI:1144407842
Name:BEATTY, YAUANA
Entity Type:Individual
Prefix:
First Name:YAUANA
Middle Name:
Last Name:BEATTY
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 1:18514 PENTECOSTAL ST
Mailing Address - Street 2:
Mailing Address - City:ELLENDALE
Mailing Address - State:DE
Mailing Address - Zip Code:19941-3358
Mailing Address - Country:US
Mailing Address - Phone:302-424-8080
Mailing Address - Fax:
Practice Address - Street 1:18514 PENTECOSTAL ST
Practice Address - Street 2:
Practice Address - City:ELLENDALE
Practice Address - State:DE
Practice Address - Zip Code:19941-3358
Practice Address - Country:US
Practice Address - Phone:302-424-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor