Provider Demographics
NPI:1871076612
Name:YODER, ANGELA MARIE (MA, NCC, LBS, LPC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:YODER
Suffix:
Gender:F
Credentials:MA, NCC, LBS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:DAVIDSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15928-9504
Mailing Address - Country:US
Mailing Address - Phone:814-691-1780
Mailing Address - Fax:
Practice Address - Street 1:2301 GRAHAM AVE
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963
Practice Address - Country:US
Practice Address - Phone:814-691-1780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010644101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC010644OtherLICENSE PROFESSIONAL COUNSELOR