Provider Demographics
NPI:1538444328
Name:SKLADER YOST, LEAH ALEXANDRA (MA)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:ALEXANDRA
Last Name:SKLADER YOST
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 TUCKER RD
Mailing Address - Street 2:PO BOX 661
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9591
Mailing Address - Country:US
Mailing Address - Phone:541-386-6665
Mailing Address - Fax:
Practice Address - Street 1:965 TUCKER RD
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9591
Practice Address - Country:US
Practice Address - Phone:541-386-6665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR1690101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health