Provider Demographics
NPI:1972549996
Name:YEATER, JULIE (AUD, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:YEATER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6005 MONCLOVA RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1864
Mailing Address - Country:US
Mailing Address - Phone:419-578-7557
Mailing Address - Fax:419-539-6335
Practice Address - Street 1:6005 MONCLOVA RD
Practice Address - Street 2:SUITE 320
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1864
Practice Address - Country:US
Practice Address - Phone:419-578-7557
Practice Address - Fax:419-539-6335
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA1100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0477583Medicaid