Provider Demographics
NPI:1760919567
Name:YEAGER, HAZLEY WILLIAMS (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HAZLEY
Middle Name:WILLIAMS
Last Name:YEAGER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 RAILROAD ST STE 102
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-1547
Mailing Address - Country:US
Mailing Address - Phone:570-979-1199
Mailing Address - Fax:570-209-5787
Practice Address - Street 1:418 RAILROAD ST STE 102
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-1547
Practice Address - Country:US
Practice Address - Phone:570-979-1199
Practice Address - Fax:570-209-5787
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011932235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist