Provider Demographics
NPI:1497436497
Name:YEARDE, YAZMYN ALECHIA (CRC)
Entity Type:Individual
Prefix:MS
First Name:YAZMYN
Middle Name:ALECHIA
Last Name:YEARDE
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CARVER LOOP APT 13A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-2934
Mailing Address - Country:US
Mailing Address - Phone:347-260-2040
Mailing Address - Fax:
Practice Address - Street 1:100 CARVER LOOP APT 13A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-2934
Practice Address - Country:US
Practice Address - Phone:347-260-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00117091225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor