Provider Demographics
NPI:1942269410
Name:YETTER, DANITA (SLP)
Entity Type:Individual
Prefix:MS
First Name:DANITA
Middle Name:
Last Name:YETTER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 54 BOX 1762
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09601
Mailing Address - Country:US
Mailing Address - Phone:011043-430-5459
Mailing Address - Fax:
Practice Address - Street 1:31MGD/SGOR
Practice Address - Street 2:UNIT 6180 BOX 245
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09604-0245
Practice Address - Country:IT
Practice Address - Phone:01139043-430-5459
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1915235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist