Provider Demographics
NPI:1366290991
Name:YAWORSKI, DARIA LEA-LUCILLE (OD)
Entity type:Individual
Prefix:DR
First Name:DARIA
Middle Name:LEA-LUCILLE
Last Name:YAWORSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DARIA
Other - Middle Name:LEA-LUCILLE
Other - Last Name:LAISURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:803 E CENTER RD
Mailing Address - Street 2:
Mailing Address - City:KINGSLEY
Mailing Address - State:MI
Mailing Address - Zip Code:49649-9243
Mailing Address - Country:US
Mailing Address - Phone:231-392-3081
Mailing Address - Fax:
Practice Address - Street 1:116 N TUSCOLA RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-6961
Practice Address - Country:US
Practice Address - Phone:898-829-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL260135493381152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist