Provider Demographics
NPI:1467167072
Name:YENTES, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:YENTES
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 1:1025 MANCHESTER AVE STE 8B
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-1425
Mailing Address - Country:US
Mailing Address - Phone:260-330-5372
Mailing Address - Fax:
Practice Address - Street 1:1025 MANCHESTER AVE STE 8B
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-1425
Practice Address - Country:US
Practice Address - Phone:260-330-5372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22007155225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist