Provider Demographics
NPI:1609234251
Name:YIGAL, OMRI
Entity Type:Individual
Prefix:
First Name:OMRI
Middle Name:
Last Name:YIGAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42082
Mailing Address - Street 2:
Mailing Address - City:HUNTER ARMY AIRFIELD
Mailing Address - State:GA
Mailing Address - Zip Code:31409
Mailing Address - Country:US
Mailing Address - Phone:912-275-9308
Mailing Address - Fax:
Practice Address - Street 1:116 ROMMEL AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31408-1714
Practice Address - Country:US
Practice Address - Phone:912-275-9308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist