Provider Demographics
NPI:1316584295
Name:YOAKUM, JUDITH ANNE (LMSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANNE
Last Name:YOAKUM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 BRANSON LANDING BLVD STE 408
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2192
Mailing Address - Country:US
Mailing Address - Phone:417-348-8313
Mailing Address - Fax:417-348-8319
Practice Address - Street 1:525 BRANSON LANDING BLVD STE 408
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2192
Practice Address - Country:US
Practice Address - Phone:417-348-8313
Practice Address - Fax:417-348-8319
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018035597104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker