Provider Demographics
NPI:1447939087
Name:YODER, KATELYN NOEL
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:NOEL
Last Name:YODER
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 1:6290 CENTRAL BLVD APT 205
Mailing Address - Street 2:
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-4404
Mailing Address - Country:US
Mailing Address - Phone:419-890-5725
Mailing Address - Fax:
Practice Address - Street 1:2626 E 46TH ST STE J
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2373
Practice Address - Country:US
Practice Address - Phone:317-754-2885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)