Provider Demographics
NPI:1063424034
Name:YELTON, LATRICIA NELON (OTR/L)
Entity type:Individual
Prefix:
First Name:LATRICIA
Middle Name:NELON
Last Name:YELTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 US HIGHWAY 74A BYP
Mailing Address - Street 2:
Mailing Address - City:SPINDALE
Mailing Address - State:NC
Mailing Address - Zip Code:28160-1873
Mailing Address - Country:US
Mailing Address - Phone:828-286-4125
Mailing Address - Fax:828-286-4156
Practice Address - Street 1:1499 US HIGHWAY 74A BYP
Practice Address - Street 2:
Practice Address - City:SPINDALE
Practice Address - State:NC
Practice Address - Zip Code:28160-1873
Practice Address - Country:US
Practice Address - Phone:828-286-4125
Practice Address - Fax:828-286-4156
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4732225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
138NTOtherBCBS