Provider Demographics
NPI:1720204183
Name:MAKIDON, YVONNE P (LMSW, LMFT, CAADC)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:P
Last Name:MAKIDON
Suffix:
Gender:F
Credentials:LMSW, LMFT, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 EMBURY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7113
Mailing Address - Country:US
Mailing Address - Phone:810-659-7242
Mailing Address - Fax:
Practice Address - Street 1:8240 EMBURY RD
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7113
Practice Address - Country:US
Practice Address - Phone:810-659-7242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801085260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health