Provider Demographics
NPI:1578771804
Name:YOCUM ENTERPRISES INC
Entity Type:Organization
Organization Name:YOCUM ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:YOCUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-417-1655
Mailing Address - Street 1:5023 E 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2158
Mailing Address - Country:US
Mailing Address - Phone:813-417-1655
Mailing Address - Fax:813-984-8358
Practice Address - Street 1:2901 W BUSCH BLVD STE 916
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4573
Practice Address - Country:US
Practice Address - Phone:813-417-1655
Practice Address - Fax:813-984-8358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003603103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty