Provider Demographics
NPI:1568912343
Name:BEYSOLOW, YUMETTA TAIYLON (MSW)
Entity Type:Individual
Prefix:MS
First Name:YUMETTA
Middle Name:TAIYLON
Last Name:BEYSOLOW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 GREENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-3041
Mailing Address - Country:US
Mailing Address - Phone:267-881-2581
Mailing Address - Fax:
Practice Address - Street 1:106 GREENWAY AVE
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-3041
Practice Address - Country:US
Practice Address - Phone:267-881-2581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional