Provider Demographics
NPI:1104555259
Name:AHERN, TEAGAN YATES
Entity type:Individual
Prefix:
First Name:TEAGAN
Middle Name:YATES
Last Name:AHERN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1260
Mailing Address - Country:US
Mailing Address - Phone:239-322-4271
Mailing Address - Fax:
Practice Address - Street 1:26 FOREST RIDGE DR UNIT 5
Practice Address - Street 2:
Practice Address - City:ROWLEY
Practice Address - State:MA
Practice Address - Zip Code:01969-2143
Practice Address - Country:US
Practice Address - Phone:603-918-1298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist