Individual
EDWARD YEATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 BRICKERTON ST, COLUMBUS, MS 39701-3608
(662) 328-3110
(662) 328-3135
Mailing address
104 BRICKERTON ST, COLUMBUS, MS 39701-3608
(662) 328-3110
(662) 328-3135
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1836
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05331850
—
MS
Enumeration date
10/07/2014
Last updated
07/10/2017
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