Provider Demographics
NPI:1891936381
Name:YAUGER, ROBERTA ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:ANN
Last Name:YAUGER
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 1:364 PATTESON DR # 522
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3202
Mailing Address - Country:US
Mailing Address - Phone:724-366-6610
Mailing Address - Fax:
Practice Address - Street 1:364 PATTESON DR # 522
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3202
Practice Address - Country:US
Practice Address - Phone:724-366-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-1049235Z00000X
PASL008633235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist