Provider Demographics
NPI:1386341808
Name:YANCEY-HALL, SAUNDRA KAY
Entity type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:KAY
Last Name:YANCEY-HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45506-2934
Mailing Address - Country:US
Mailing Address - Phone:937-398-9263
Mailing Address - Fax:
Practice Address - Street 1:1918 MECHANICSBURG RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-3147
Practice Address - Country:US
Practice Address - Phone:937-399-6101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator