Provider Demographics
NPI:1891193629
Name:YECHA, CODY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:YECHA
Suffix:
Gender:M
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 BELLERIVE DR APT Y-246
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-8808
Mailing Address - Country:US
Mailing Address - Phone:509-675-1222
Mailing Address - Fax:
Practice Address - Street 1:2100 BELLERIVE DR APT Y-246
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-8808
Practice Address - Country:US
Practice Address - Phone:509-675-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60517959235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist