Provider Demographics
NPI:1932272937
Name:YAHNKE, GLADYS LEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:LEE
Last Name:YAHNKE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6116 BIGHORN XING
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6544
Mailing Address - Country:US
Mailing Address - Phone:970-631-4661
Mailing Address - Fax:970-797-1349
Practice Address - Street 1:375 E HORSETOOTH RD
Practice Address - Street 2:BLDG 2 STE 201
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3155
Practice Address - Country:US
Practice Address - Phone:970-631-3037
Practice Address - Fax:970-797-1349
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2978103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist