Provider Demographics
NPI:1649738824
Name:YONKERS, EMMA C
Entity Type:Individual
Prefix:MS
First Name:EMMA
Middle Name:C
Last Name:YONKERS
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 1:4050 W PINE BLVD APT 3207
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-3349
Mailing Address - Country:US
Mailing Address - Phone:847-436-5331
Mailing Address - Fax:
Practice Address - Street 1:4050 W PINE BLVD APT 3207
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3349
Practice Address - Country:US
Practice Address - Phone:847-436-5331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer