Doctor Name: | AMY D YODER |
NPI Number: | 1164652574 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 22004681A |
Business Practice Address: | 12910 Clydesdale Ct Fort Wayne, IN - 468147490 |
Business Phone Number: | 2606720268 |
Business Fax Number: | |
Mailing Address: | 12910 Clydesdale Ct, FORT WAYNE |
State: | IN |
Postal Code: | 468147490 |
Phone Number: | 2606720268 |
Fax Number: | |
NPI Enumeration Date: | 07/20/2009 |
NPI Last Update Date: | 07/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22004681A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |