Individual
ANSLEM GENE YAZZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., M.A.
Contact information
Practice address
119 S SPRING ST, FLAGSTAFF, AZ 86001-4472
(928) 853-2049
Mailing address
119 S SPRING ST, FLAGSTAFF, AZ 86001-4472
(928) 853-2049
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
962713
—
AZ
Enumeration date
01/08/2007
Last updated
07/25/2007
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