Individual
MICHAEL YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
23 N CHESTER ST, BALTIMORE, MD 21231-1626
(270) 314-8315
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1730
KY
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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