Provider Demographics
NPI:1497091318
Name:YATES, CASEY M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:M
Last Name:YATES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:M
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3525 NW 56TH ST STE 150A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4548
Mailing Address - Country:US
Mailing Address - Phone:405-548-4300
Mailing Address - Fax:405-548-4350
Practice Address - Street 1:3525 NW 56TH ST STE 150A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4548
Practice Address - Country:US
Practice Address - Phone:405-548-4300
Practice Address - Fax:405-548-4350
Is Sole Proprietor?:No
Enumeration Date:2012-12-20
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist