Provider Demographics
NPI:1629776596
Name:YANDO, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:YANDO
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 1:15453 LOOKOUT RD APT 9302
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3986
Mailing Address - Country:US
Mailing Address - Phone:518-577-3718
Mailing Address - Fax:
Practice Address - Street 1:2967 OAK RUN PKWY STE 505
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-5379
Practice Address - Country:US
Practice Address - Phone:518-577-3718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCP027822T225100000X
TX1352939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist