Healthcare Provider Details

I. General information

NPI: 1972549996
Provider Name (Legal Business Name): JULIE YEATER AUD, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 CHERRY ST STE M800
TOLEDO OH
43608-2676
US

IV. Provider business mailing address

2213 CHERRY ST
TOLEDO OH
43608-2603
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-1022
  • Fax: 419-251-1021
Mailing address:
  • Phone: 419-251-7960
  • Fax: 419-251-3816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA1100
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: