Provider Demographics
NPI:1174960538
Name:YODER, MARIA ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANN
Last Name:YODER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 FULTON RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-9623
Mailing Address - Country:US
Mailing Address - Phone:330-435-4854
Mailing Address - Fax:
Practice Address - Street 1:1640 FULTON RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-9623
Practice Address - Country:US
Practice Address - Phone:330-435-4854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-25
Last Update Date:2013-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03131856183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist