Provider Demographics
NPI:1225810344
Name:I AM YANA MO
Entity Type:Organization
Organization Name:I AM YANA MO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEAYANA
Authorized Official - Middle Name:NICOLA
Authorized Official - Last Name:MINUS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:478-262-9997
Mailing Address - Street 1:1000 CORPORATE POINTE STE 309
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-3441
Mailing Address - Country:US
Mailing Address - Phone:478-262-9997
Mailing Address - Fax:
Practice Address - Street 1:370 E 160TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-4404
Practice Address - Country:US
Practice Address - Phone:478-262-9997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty