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Individual

MR. DESMOND EUGENE YANAMAYU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LISW-S

Contact information

Practice address
13110 SHAKER SQ STE C-200F, CLEVELAND, OH 44120
(330) 518-4863
Mailing address
4531 EMERSON RD, SOUTH EUCLID, OH 44121-3929
(330) 518-4863

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
SW129424
PA
1041C0700X
Clinical Social Worker
Primary
I.1600280
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0247553
OH
Enumeration date
11/08/2012
Last updated
07/21/2022
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