Provider Demographics
NPI:1699561118
Name:YEOMAN, KAELYN
Entity type:Individual
Prefix:
First Name:KAELYN
Middle Name:
Last Name:YEOMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-3017
Mailing Address - Country:US
Mailing Address - Phone:620-717-3040
Mailing Address - Fax:
Practice Address - Street 1:1649 61ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-2110
Practice Address - Country:US
Practice Address - Phone:620-717-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst