Provider Demographics
NPI:1861837494
Name:YABKO, STEPHANIE VOIGT (PSYD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:VOIGT
Last Name:YABKO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:VOIGT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:265 E 100 S STE 250
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-1643
Mailing Address - Country:US
Mailing Address - Phone:801-483-2447
Mailing Address - Fax:801-486-8705
Practice Address - Street 1:265 E 100 S STE 250
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-1643
Practice Address - Country:US
Practice Address - Phone:801-483-2447
Practice Address - Fax:801-486-8705
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8819354-2501103TC0700X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist