Provider Demographics
NPI:1316371487
Name:YABKO, BRANDON ANDREW (PHD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:ANDREW
Last Name:YABKO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2681 E PARLEYS WAY STE 203
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-1630
Mailing Address - Country:US
Mailing Address - Phone:661-312-9335
Mailing Address - Fax:
Practice Address - Street 1:2681 E PARLEYS WAY STE 203
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-1630
Practice Address - Country:US
Practice Address - Phone:385-355-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8819350-2501103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling