Provider Demographics
NPI:1609088657
Name:WARD, YVETTE CHRISTINE (MSCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:CHRISTINE
Last Name:WARD
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:CHRISTINE
Other - Last Name:SOLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:60 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-6152
Mailing Address - Country:US
Mailing Address - Phone:386-586-6639
Mailing Address - Fax:
Practice Address - Street 1:1055 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-4101
Practice Address - Country:US
Practice Address - Phone:386-252-3686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist