Individual
MS. STACIE YELDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A,, MT-BC, AVPT
Contact information
Practice address
552 VENICE BLVD, VENICE, CA 90291-4212
(424) 230-6335
Mailing address
552 VENICE BLVD, VENICE, CA 90291-4212
(424) 230-6335
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
07920
PA
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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