Provider Demographics
NPI:1578034419
Name:JENNIFER N YODER P.A.
Entity Type:Organization
Organization Name:JENNIFER N YODER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:YODER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-417-3820
Mailing Address - Street 1:7050 W PALMETTO PARK RD STE 15-149
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3426
Mailing Address - Country:US
Mailing Address - Phone:954-417-3820
Mailing Address - Fax:
Practice Address - Street 1:7050 W PALMETTO PARK RD STE 15-149
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3426
Practice Address - Country:US
Practice Address - Phone:954-417-3820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty