Provider Demographics
NPI:1013137744
Name:YAEGER, STEPHEN I (PHD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:I
Last Name:YAEGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SAN REMO AVE
Mailing Address - Street 2:#178
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3043
Mailing Address - Country:US
Mailing Address - Phone:305-661-8228
Mailing Address - Fax:305-661-6148
Practice Address - Street 1:1500 SAN REMO AVE
Practice Address - Street 2:#178
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3043
Practice Address - Country:US
Practice Address - Phone:305-661-8228
Practice Address - Fax:305-661-6148
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0002704103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical