Provider Demographics
NPI:1326769050
Name:YAICH, CORI MARGARET
Entity Type:Individual
Prefix:MISS
First Name:CORI
Middle Name:MARGARET
Last Name:YAICH
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 1:210 BUTLER AVE NW APT 301
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-1356
Mailing Address - Country:US
Mailing Address - Phone:614-499-8368
Mailing Address - Fax:
Practice Address - Street 1:331 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-1347
Practice Address - Country:US
Practice Address - Phone:330-627-4313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH19780554OtherUMR