Healthcare Provider Details

I. General information

NPI: 1013235167
Provider Name (Legal Business Name): JANE YEATTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 05/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3544 N PROGRESS AVE SUITE 110
HARRISBURG PA
17110-9480
US

IV. Provider business mailing address

3544 N PROGRESS AVE SUITE 110
HARRISBURG PA
17110-9480
US

V. Phone/Fax

Practice location:
  • Phone: 717-901-7380
  • Fax: 717-901-7383
Mailing address:
  • Phone: 717-901-7380
  • Fax: 717-901-7383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC004185
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: