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General NPI Number Information
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NPI Number | 1003698796
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Entity Type | Individual
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Provider Name | KAISHA D. YEAGER LPC-ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 1301 ROOSEVELT ST
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City | BORGER
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State | TX
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Zip | 79007-4427
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Country | US
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Telephone | 806-457-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 103 OZMER ST
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City | BORGER
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State | TX
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Zip | 79007-6613
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Country | US
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Telephone | 806-274-1668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 90921
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License Number State | TX
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