Provider Demographics
NPI:1962293498
Name:ARYA ADULT RECOVERY AND YOUTH ALLIANCE
Entity type:Organization
Organization Name:ARYA ADULT RECOVERY AND YOUTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TIERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:YONKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CSAC, ICS
Authorized Official - Phone:920-266-9712
Mailing Address - Street 1:498 WISCONSIN CT
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54937-1844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:498 WISCONSIN CT
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54937-1844
Practice Address - Country:US
Practice Address - Phone:920-266-9712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health