Provider Demographics
NPI:1528232634
Name:YATSKY, SUSAN D (LAC,DIPLAC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:D
Last Name:YATSKY
Suffix:
Gender:F
Credentials:LAC,DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 VALLEY FORGE RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2676
Mailing Address - Country:US
Mailing Address - Phone:610-935-3455
Mailing Address - Fax:
Practice Address - Street 1:1220 VALLEY FORGE RD
Practice Address - Street 2:SUITE 30
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2676
Practice Address - Country:US
Practice Address - Phone:610-935-3455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist