Provider Demographics
NPI:1124221296
Name:YAMOKOSKI, CYNTHIA A (PHD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:YAMOKOSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CURRIE HALL PKWY
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4312
Mailing Address - Country:US
Mailing Address - Phone:330-673-5812
Mailing Address - Fax:330-673-7162
Practice Address - Street 1:190 CURRIE HALL PKWY
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4312
Practice Address - Country:US
Practice Address - Phone:330-673-5812
Practice Address - Fax:330-673-7162
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10024Medicaid
OH10034Medicaid