Provider Demographics
NPI:1700931730
Name:YAMAGIWA, MAIKO (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MAIKO
Middle Name:
Last Name:YAMAGIWA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8175 S VIRGINIA ST
Mailing Address - Street 2:STE. 850 PMB 331
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8922
Mailing Address - Country:US
Mailing Address - Phone:775-852-4342
Mailing Address - Fax:775-852-9136
Practice Address - Street 1:150 W HUFFAKER LN
Practice Address - Street 2:STE. 105
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2092
Practice Address - Country:US
Practice Address - Phone:775-852-4342
Practice Address - Fax:775-852-9136
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV946235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist