Provider Demographics
NPI:1760620140
Name:MCGILL, YASSMIN A (M ED)
Entity Type:Individual
Prefix:MRS
First Name:YASSMIN
Middle Name:A
Last Name:MCGILL
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 MORNING GLORY LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4256
Mailing Address - Country:US
Mailing Address - Phone:321-939-4166
Mailing Address - Fax:321-939-4166
Practice Address - Street 1:804 N HOAGLAND BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4518
Practice Address - Country:US
Practice Address - Phone:407-931-2911
Practice Address - Fax:407-931-2711
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLYM 5101OtherSOCIAL WORKER / COUNSELOR