Provider Demographics
NPI:1104595727
Name:YANDT, TRUDI KAY (SLP)
Entity type:Individual
Prefix:MS
First Name:TRUDI
Middle Name:KAY
Last Name:YANDT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38201 W INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:TONOPAH
Mailing Address - State:AZ
Mailing Address - Zip Code:85354-8671
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:38201 W INDIAN SCHOOL RD # 90
Practice Address - Street 2:
Practice Address - City:TONOPAH
Practice Address - State:AZ
Practice Address - Zip Code:85354-8671
Practice Address - Country:US
Practice Address - Phone:575-562-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP14526235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist