Provider Demographics
NPI:1790572105
Name:PATIN, YVONNE ELIZABETH
Entity type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:ELIZABETH
Last Name:PATIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 KEENE CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2691
Mailing Address - Country:US
Mailing Address - Phone:504-401-4056
Mailing Address - Fax:
Practice Address - Street 1:2012 KEENE CIR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2691
Practice Address - Country:US
Practice Address - Phone:504-401-4056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000736828103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty