MEDICARE: MRS. YVETTE CHRISTINE WARD M.S.CCC-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	SA7250	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609088657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YVETTE CHRISTINE WARD M.S.CCC-SLP

Provider Business Mailing Address
First Line	:	60 EASTWOOD DR
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-6152
Country	:	US
Telephone Number	:	386-586-6639
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 3RD ST
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-4101
Country	:	US
Telephone Number	:	386-252-3686
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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