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General NPI Number Information
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NPI Number | 1639035785
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Entity Type | Individual
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Provider Name | LUCY YAGER
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Gender | Female
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 2301 W BRADLEY AVE STE 1
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City | CHAMPAIGN
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State | IL
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Zip | 61821-1814
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Country | US
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Telephone | 574-387-4313
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Fax | 574-204-2868
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Provider Business Mailing Address
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Address Line | 1827 E IRELAND RD
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City | SOUTH BEND
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State | IN
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Zip | 46614-2845
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Country | US
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Telephone | 574-387-4313
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Fax | 574-204-2868
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-505248
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License Number State | IL
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