Provider Demographics
NPI:1366414781
Name:YODER, HARVEY (MED)
Entity type:Individual
Prefix:MR
First Name:HARVEY
Middle Name:
Last Name:YODER
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 NEWMAN AVE
Mailing Address - Street 2:FAMILY LIFE RESOURCE CENTER
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801
Mailing Address - Country:US
Mailing Address - Phone:540-434-8450
Mailing Address - Fax:540-433-3805
Practice Address - Street 1:273 NEWMAN AVE
Practice Address - Street 2:FAMILY LIFE RESOURCE CENTER
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:540-434-8450
Practice Address - Fax:540-433-3805
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001684103T00000X
VA0717000403106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA693769OtherANTHEM
VA085472OtherSOUTHERN HEALTH
VA5400147Medicaid
156869OtherCOMPANY CH
6497OtherUNITED B LT