Provider Demographics
NPI:1295914588
Name:MIYAMOTO, YOSHIKO N/A (MA)
Entity type:Individual
Prefix:MS
First Name:YOSHIKO
Middle Name:N/A
Last Name:MIYAMOTO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1599 BENTON ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214
Mailing Address - Country:US
Mailing Address - Phone:303-778-1548
Mailing Address - Fax:
Practice Address - Street 1:1599 BENTON ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-1734
Practice Address - Country:US
Practice Address - Phone:303-778-1548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor