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General NPI Number Information
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NPI Number | 1396038295
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Entity Type | Organization
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Legal Business Name | YAGER THERAPY ENTERPRISES, INC.
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 11201 SW 108TH AVE
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City | MIAMI
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State | FL
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Zip | 33176-3905
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Country | US
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Telephone | 305-926-1377
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Fax | 786-250-5444
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Provider Business Mailing Address
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Address Line | 11201 SW 108TH AVE
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City | MIAMI
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State | FL
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Zip | 33176-3905
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Country | US
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Telephone | 305-926-1377
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Fax | 786-250-5444
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST/DIRECTOR
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Name | MISS JENNIFER DENISE YAGER
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Credential | M.A., CCC-SLP
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Telephone | 305-926-1377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA 7647
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License Number State | FL
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