Provider Demographics
NPI:1598942955
Name:YEATER, MONICA WOOD (PSYD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:WOOD
Last Name:YEATER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 N FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5893
Mailing Address - Country:US
Mailing Address - Phone:724-222-2265
Mailing Address - Fax:724-222-2254
Practice Address - Street 1:2111 N FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5893
Practice Address - Country:US
Practice Address - Phone:724-222-2265
Practice Address - Fax:724-222-2254
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015995103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029095620001Medicaid