| Doctor Name: | MISS LAURA SUZANNA YANDRICHA |
| NPI Number: | 1154560753 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CADC |
| License Number: | NA |
| Business Practice Address: | 14625 Ne 23rd St Choctaw, OK - 730208728 |
| Business Phone Number: | 4053908131 |
| Business Fax Number: | 4056010324 |
| Mailing Address: | Po Box 695, CHOCTAW |
| State: | OK |
| Postal Code: | 730200695 |
| Phone Number: | 4053908131 |
| Fax Number: | 4056010324 |
| NPI Enumeration Date: | 02/05/2009 |
| NPI Last Update Date: | 02/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | NA |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |