Provider Demographics
NPI:1598999633
Name:YEAGER, MICHAEL WILLIAM (MS CCC-SLP MSLBE)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:YEAGER
Suffix:
Gender:M
Credentials:MS CCC-SLP MSLBE
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Other - First Name:
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Mailing Address - Street 1:5500 BROOKTREE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9260
Mailing Address - Country:US
Mailing Address - Phone:724-940-3468
Mailing Address - Fax:724-940-3969
Practice Address - Street 1:5500 BROOKTREE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9260
Practice Address - Country:US
Practice Address - Phone:724-940-3468
Practice Address - Fax:724-940-3969
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASL007948235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist