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General NPI Number Information
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NPI Number | 1649812348
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Entity Type | Individual
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Provider Name | ANTORIA YATES
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Gender | Female
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 11821 18TH PL E UNIT 212
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City | BRADENTON
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State | FL
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Zip | 34211-5095
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Country | US
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Telephone | 863-244-9703
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Fax |
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Provider Business Mailing Address
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Address Line | 4451 PARLIAMENT PL STE A
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City | LANHAM
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State | MD
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Zip | 20706-1868
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Country | US
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Telephone |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | LL61588923
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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