Provider Demographics
NPI:1265118830
Name:YENGLIN, BROOKE (ACT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:YENGLIN
Suffix:
Gender:F
Credentials:ACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19271 SD HIGHWAY 79
Mailing Address - Street 2:
Mailing Address - City:VALE
Mailing Address - State:SD
Mailing Address - Zip Code:57788-3034
Mailing Address - Country:US
Mailing Address - Phone:605-309-5105
Mailing Address - Fax:
Practice Address - Street 1:19271 SD HIGHWAY 79
Practice Address - Street 2:
Practice Address - City:VALE
Practice Address - State:SD
Practice Address - Zip Code:57788-3034
Practice Address - Country:US
Practice Address - Phone:605-309-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)