Provider Demographics
NPI:1679902100
Name:YODER, SHARI
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:YODER
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 1:3926 NOYES CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2767
Mailing Address - Country:US
Mailing Address - Phone:443-991-0607
Mailing Address - Fax:
Practice Address - Street 1:3926 NOYES CIR APT 101
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-2767
Practice Address - Country:US
Practice Address - Phone:443-991-0607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040084051041C0700X
MD160601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical