Provider Demographics
NPI:1356956171
Name:YODER, JADE ELIZABETH (BS)
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:ELIZABETH
Last Name:YODER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7375 W US HIGHWAY 52
Mailing Address - Street 2:
Mailing Address - City:NEW PALESTINE
Mailing Address - State:IN
Mailing Address - Zip Code:46163-8950
Mailing Address - Country:US
Mailing Address - Phone:888-877-7222
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:300 N 10TH ST
Practice Address - Street 2:
Practice Address - City:GAS CITY
Practice Address - State:IN
Practice Address - Zip Code:46933-1605
Practice Address - Country:US
Practice Address - Phone:888-877-7222
Practice Address - Fax:179-782-7033
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
INRBT-16-27081106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician