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NPI Code Detail

MEDICARE: MS. CATHERINE YEAGER PHD

MEDICARE: MS. CATHERINE YEAGER PHD
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
1103TC2200XClinical Child & Adolescent Psychologist360ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2288L5YEOTHERMNMN BC/BS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
424908OTHERNDND BC/BS

General Provider Information

NPI Number : 1770549032
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CATHERINE YEAGER PHD
Provider Business Mailing Address
First Line : 3535 S 31ST ST STE 201
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-3593
Country : US
Telephone Number : 701-780-6821
Fax Number : 701-780-1973
Provider Business Practice Location Address
First Line : 3535 S 31ST ST STE 201
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-3593
Country : US
Telephone Number : 701-780-6821
Fax Number : 701-780-1973
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 09/07/2018

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Directions to “ MS. CATHERINE YEAGER PHD” Practice Location

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