Provider Demographics
NPI:1417081662
Name:YAP, MARIA ANGELICA (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANGELICA
Last Name:YAP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANGELICA
Other - Last Name:GELILIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:217 E SOUTHWAY BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902
Mailing Address - Country:US
Mailing Address - Phone:765-236-8775
Mailing Address - Fax:
Practice Address - Street 1:217 E SOUTHWAY BLVD STE 106
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3577
Practice Address - Country:US
Practice Address - Phone:765-236-8775
Practice Address - Fax:765-236-8785
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008750A171W00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171W00000XOther Service ProvidersContractor