Healthcare Provider Details

I. General information

NPI: 1639736952
Provider Name (Legal Business Name): DONNA YAKE M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8309 HIGH ST NE
WARREN OH
44484-1926
US

IV. Provider business mailing address

280 CONCORD RD
HERMITAGE PA
16148-2642
US

V. Phone/Fax

Practice location:
  • Phone: 330-726-3339
  • Fax:
Mailing address:
  • Phone: 724-699-7432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberIL03396
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: