Provider Demographics
NPI:1922396217
Name:YAKAITIS, HEATHER (LPC, BCBA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:YAKAITIS
Suffix:
Gender:F
Credentials:LPC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5275
Mailing Address - Country:US
Mailing Address - Phone:610-349-1824
Mailing Address - Fax:188-859-7849
Practice Address - Street 1:701 E MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-5275
Practice Address - Country:US
Practice Address - Phone:610-349-1824
Practice Address - Fax:188-859-7849
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1096667103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst