Provider Demographics
NPI:1336773084
Name:YACKOSKI, KATLYN MICHELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATLYN
Middle Name:MICHELLE
Last Name:YACKOSKI
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 1:48 STONEY LN
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-2409
Mailing Address - Country:US
Mailing Address - Phone:570-706-5972
Mailing Address - Fax:
Practice Address - Street 1:48 STONEY LN
Practice Address - Street 2:
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-2409
Practice Address - Country:US
Practice Address - Phone:570-706-5972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist