Provider Demographics
NPI:1730659426
Name:ATWOOD, YESSENIA
Entity type:Individual
Prefix:MRS
First Name:YESSENIA
Middle Name:
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W YUKON DR UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-3784
Mailing Address - Country:US
Mailing Address - Phone:928-261-9907
Mailing Address - Fax:
Practice Address - Street 1:4610 S 12TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-2314
Practice Address - Country:US
Practice Address - Phone:602-232-4920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant