Provider Demographics
NPI:1811432446
Name:GARCIA PEDROZA, YADIRA
Entity type:Individual
Prefix:
First Name:YADIRA
Middle Name:
Last Name:GARCIA PEDROZA
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:PO BOX 198
Mailing Address - Street 2:
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124-0198
Mailing Address - Country:US
Mailing Address - Phone:620-388-9102
Mailing Address - Fax:620-672-2567
Practice Address - Street 1:108 S PINE ST
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-2739
Practice Address - Country:US
Practice Address - Phone:620-388-9102
Practice Address - Fax:620-672-2567
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist