Provider Demographics
NPI:1447595962
Name:YATES, BECKY L
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:L
Last Name:YATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-7558
Mailing Address - Country:US
Mailing Address - Phone:509-736-1563
Mailing Address - Fax:
Practice Address - Street 1:125 S CONWAY PL
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3159
Practice Address - Country:US
Practice Address - Phone:509-222-5028
Practice Address - Fax:509-222-5056
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00002857235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist