Provider Demographics
NPI:1073936654
Name:YEAMAN, KYE JETONNE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:KYE
Middle Name:JETONNE
Last Name:YEAMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 N OCEAN BLVD
Mailing Address - Street 2:#4A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5340
Mailing Address - Country:US
Mailing Address - Phone:561-212-8210
Mailing Address - Fax:
Practice Address - Street 1:2255 GLADES RD
Practice Address - Street 2:SUITE 324A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7382
Practice Address - Country:US
Practice Address - Phone:561-212-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-02
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2871106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist