Provider Demographics
NPI:1447579776
Name:YEAGER, ANN L (COTA/L)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:YEAGER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ACORN LN
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-3725
Mailing Address - Country:US
Mailing Address - Phone:724-532-0369
Mailing Address - Fax:
Practice Address - Street 1:500 BROUWERS DR
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2500
Practice Address - Country:US
Practice Address - Phone:724-537-6149
Practice Address - Fax:724-537-6156
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP002866L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant