Provider Demographics
NPI:1700039229
Name:YEARWOOD, NATASHA ANGELINE (MT-BC)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:ANGELINE
Last Name:YEARWOOD
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 S 10TH ST
Mailing Address - Street 2:APT. 20
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-7131
Mailing Address - Country:US
Mailing Address - Phone:218-791-4220
Mailing Address - Fax:
Practice Address - Street 1:3435 S 10TH ST
Practice Address - Street 2:APT. 20
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-7131
Practice Address - Country:US
Practice Address - Phone:218-791-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist