Provider Demographics
NPI:1538348636
Name:YADAO, NANCY ABENA
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ABENA
Last Name:YADAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:BAIS
Other - Last Name:ABENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3290 N RIDGE RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3655
Mailing Address - Country:US
Mailing Address - Phone:443-535-5465
Mailing Address - Fax:
Practice Address - Street 1:3290 N RIDGE RD
Practice Address - Street 2:SUITE 290
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-3655
Practice Address - Country:US
Practice Address - Phone:443-535-5465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist