Healthcare Provider Details

I. General information

NPI: 1548452840
Provider Name (Legal Business Name): ERIN E YEAGER CFY-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6865 E BECKER LN STE 101
SCOTTSDALE AZ
85254-6730
US

IV. Provider business mailing address

1410 E KAEL ST
MESA AZ
85203-2006
US

V. Phone/Fax

Practice location:
  • Phone: 480-991-6560
  • Fax:
Mailing address:
  • Phone: 480-650-9575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberTSLP5580
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: