Most Relevant Information
Provider Data
| NPI Number: | 1003319781 |
| Provider Name: | STEPHANIE YATES LCPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 18457-130 |
Most Important Dates
| Enumeration Date: | 03/09/2018 |
| Last Updated: | 06/15/2022 |
Provider Practice Location
6072 BRYNWOOD DR STE 107
ROCKFORD
IL
611145829
Practice Location Phone/Fax
| Phone: | 8158460684 |
| Fax: |
Provider Mailing Location
6072 BRYNWOOD DR STE 107
ROCKFORD
IL
611145829
Provider Mailing Phone/Fax
| Phone: | 8158460684 |
| Fax: |