Provider Demographics
NPI:1962435289
Name:GARMON, YOLANDA TEREHAUN (PSYD)
Entity type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:TEREHAUN
Last Name:GARMON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S MAIN ST STE 1130
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2419
Mailing Address - Country:US
Mailing Address - Phone:937-272-3267
Mailing Address - Fax:937-223-3026
Practice Address - Street 1:211 S MAIN ST STE 1130
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2419
Practice Address - Country:US
Practice Address - Phone:937-272-3267
Practice Address - Fax:937-223-3026
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6109103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHGA4177861Medicare ID - Type Unspecified