Provider Demographics
NPI:1740498948
Name:TUBBS, CAROLYN YUVONDA (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:YUVONDA
Last Name:TUBBS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 RACE ST
Mailing Address - Street 2:MAIL STOP 905, 4TH FLOOR, SUITE 403-, BELLET BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1119
Mailing Address - Country:US
Mailing Address - Phone:215-762-6930
Mailing Address - Fax:215-762-1153
Practice Address - Street 1:1505 RACE ST
Practice Address - Street 2:MAIL STOP 905, 4TH FLOOR, SUITE 403-, BELLET BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1119
Practice Address - Country:US
Practice Address - Phone:215-762-6930
Practice Address - Fax:215-762-1153
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist