Provider Demographics
NPI:1801913314
Name:GWIN, YVETTE ELAINA (CMT)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:ELAINA
Last Name:GWIN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 WOODDUCK CT
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-9214
Mailing Address - Country:US
Mailing Address - Phone:530-533-3224
Mailing Address - Fax:530-533-3224
Practice Address - Street 1:4405 WOODDUCK CT
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-9214
Practice Address - Country:US
Practice Address - Phone:530-533-3224
Practice Address - Fax:530-533-3224
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist