Provider Demographics
NPI:1376068072
Name:YAUCHLER, MARCY KATHERINE (MTA)
Entity Type:Individual
Prefix:MS
First Name:MARCY
Middle Name:KATHERINE
Last Name:YAUCHLER
Suffix:
Gender:F
Credentials:MTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 ROSERY RD NE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-1682
Mailing Address - Country:US
Mailing Address - Phone:727-638-0994
Mailing Address - Fax:
Practice Address - Street 1:35080 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1925
Practice Address - Country:US
Practice Address - Phone:727-789-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL52441455941246ZA2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical