Provider Demographics
NPI:1619449949
Name:YOKUBONIS, AL (BCPC)
Entity type:Individual
Prefix:
First Name:AL
Middle Name:
Last Name:YOKUBONIS
Suffix:
Gender:M
Credentials:BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 E SHEA BLVD STE 117
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3339
Mailing Address - Country:US
Mailing Address - Phone:480-540-8050
Mailing Address - Fax:
Practice Address - Street 1:3509 E SHEA BLVD STE 117
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3339
Practice Address - Country:US
Practice Address - Phone:480-540-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral