Basic Information
| Provider Information | |||||||||
| NPI: | 1063601201 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YUILLE | ||||||||
| FirstName: | CAROLYN | ||||||||
| MiddleName: | COLLINS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 CHESHIRE PKWY N | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554464103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7632684115 | ||||||||
| FaxNumber: | 7632684430 | ||||||||
| Practice Location | |||||||||
| Address1: | 1135 E ROUTE 66 | ||||||||
| Address2: | STE 111 | ||||||||
| City: | GLENDORA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917403700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269145661 | ||||||||
| FaxNumber: | 6263351570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2007 | ||||||||
| LastUpdateDate: | 01/19/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | AU2509 | CA | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.