Provider Demographics
NPI:1225546815
Name:YODER, SABRINA MARIE
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:MARIE
Last Name:YODER
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:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:THOMAS
Mailing Address - State:OK
Mailing Address - Zip Code:73669-0415
Mailing Address - Country:US
Mailing Address - Phone:580-727-5751
Mailing Address - Fax:
Practice Address - Street 1:115 EAST 1ST STREET
Practice Address - Street 2:WATONGA
Practice Address - City:OK
Practice Address - State:OK
Practice Address - Zip Code:73772
Practice Address - Country:US
Practice Address - Phone:580-727-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator