Provider Demographics
NPI:1538238563
Name:THE HOPI TRIBE-THE HOPI GUIDANCE CENTER
Entity type:Organization
Organization Name:THE HOPI TRIBE-THE HOPI GUIDANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YUKIWMA
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:928-737-6300
Mailing Address - Street 1:OFF HWY 264 TOREVA ROAD
Mailing Address - Street 2:
Mailing Address - City:SECOND MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:86043-0068
Mailing Address - Country:US
Mailing Address - Phone:928-737-2685
Mailing Address - Fax:928-737-2667
Practice Address - Street 1:OFF HWY 264 TOREVA ROAD
Practice Address - Street 2:
Practice Address - City:SECOND MESA
Practice Address - State:AZ
Practice Address - Zip Code:86043-0068
Practice Address - Country:US
Practice Address - Phone:928-737-2685
Practice Address - Fax:928-737-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ449282OtherDR. GEORGIA YUKIWMA
AZ405862Medicaid