Provider Demographics
NPI:1972549996
Name:YEATER, JULIE (AUD, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:YEATER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-2603
Mailing Address - Country:US
Mailing Address - Phone:419-251-7960
Mailing Address - Fax:419-251-3816
Practice Address - Street 1:2222 CHERRY ST STE M800
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2676
Practice Address - Country:US
Practice Address - Phone:419-251-1022
Practice Address - Fax:419-251-1021
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA1100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0477583Medicaid