Provider Demographics
NPI:1437238094
Name:RYBOLT, YVETTE DAWSON (PHD)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:DAWSON
Last Name:RYBOLT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MAIN ST
Mailing Address - Street 2:STE 201
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601
Mailing Address - Country:US
Mailing Address - Phone:541-281-0727
Mailing Address - Fax:541-882-7111
Practice Address - Street 1:501 MAIN ST
Practice Address - Street 2:STE 201
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601
Practice Address - Country:US
Practice Address - Phone:541-281-0727
Practice Address - Fax:541-882-7111
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0R1256103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist