MEDICARE: YVETTE PHILANA STENNETT SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA14827	FL

General Provider Information

NPI Number	:	1588241061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVETTE PHILANA STENNETT SLP

Provider Business Mailing Address
First Line	:	8708 OPAL DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-7273
Country	:	US
Telephone Number	:	850-879-1682
Fax Number	:

Provider Business Practice Location Address
First Line	:	8708 OPAL DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-7273
Country	:	US
Telephone Number	:	850-879-1682
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2021
Last Update Date	:	03/29/2021

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Directions to “ YVETTE PHILANA STENNETT SLP” Practice Location

Language	Start Address	Practice Location

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