Provider Demographics
NPI:1710597828
Name:YOST, CARLY TAYLOR
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:TAYLOR
Last Name:YOST
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 1:321 NORRISTOWN RD STE 220
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2793
Mailing Address - Country:US
Mailing Address - Phone:267-455-8042
Mailing Address - Fax:
Practice Address - Street 1:321 NORRISTOWN RD STE 220
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2793
Practice Address - Country:US
Practice Address - Phone:866-736-9654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC016300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist