Provider Demographics
NPI:1710107388
Name:YAT, RUEY YOA
Entity Type:Individual
Prefix:MR
First Name:RUEY
Middle Name:YOA
Last Name:YAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 DODGE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-3218
Mailing Address - Country:US
Mailing Address - Phone:402-554-0759
Mailing Address - Fax:402-561-9724
Practice Address - Street 1:3610 DODGE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-3218
Practice Address - Country:US
Practice Address - Phone:402-554-0759
Practice Address - Fax:402-561-9724
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8287101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025485800Medicaid