Yana Poulos, ND
Individual provider Active NPI Naturopath · Fenton, MI
NPI 1700510427 · NPPES record last updated Jul 11, 2022
Key facts
- NPI
- 1700510427
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- 0055 (NH)
- Practice address
- 11390 Audubon St
Fenton, MI 48430-8898 - Phone
- (248) 217-6203
- Fax
- (248) 277-5586
- NPI assigned
- Jul 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0055 | NH | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 0055 | NH | Yes |
Addresses
Primary practice location
11390 Audubon St
Fenton, MI 48430-8898
Mailing address
11390 Audubon St
Fenton, MI 48430-8898
Phone (248) 217-6203
Other providers in Fenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.