Provider Demographics
NPI:1912055427
Name:ARCHIBALD, YVONNE (MSW)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
Last Name:ARCHIBALD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4459 EAGLE CREEK PKWY APT 104
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-4373
Mailing Address - Country:US
Mailing Address - Phone:317-388-1263
Mailing Address - Fax:
Practice Address - Street 1:3225 N MERIDIAN ST
Practice Address - Street 2:200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4672
Practice Address - Country:US
Practice Address - Phone:317-923-6093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker