Provider Demographics
NPI:1811282072
Name:YOHO, JACQUELINE MARY (MS)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:MARY
Last Name:YOHO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 S 6TH STREET RD
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-5735
Mailing Address - Country:US
Mailing Address - Phone:217-525-8332
Mailing Address - Fax:217-789-1420
Practice Address - Street 1:1517 WOOD MILL DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-6572
Practice Address - Country:US
Practice Address - Phone:217-698-0107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-003223235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist