Provider Demographics
NPI:1639811573
Name:YARBROUGH, ELAINA LAING (OTR/L)
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:LAING
Last Name:YARBROUGH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ELAINA
Other - Middle Name:LAING
Other - Last Name:HANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:480 E MERRIMAC DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-2609
Mailing Address - Country:US
Mailing Address - Phone:321-446-2861
Mailing Address - Fax:
Practice Address - Street 1:4450 W EAU GALLIE BLVD STE 180
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-7277
Practice Address - Country:US
Practice Address - Phone:321-255-6627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT22371225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist