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Organization
YAKETY YAK SPEECH-LANGUAGE PATHOLOGISTS, INC.
Active
Organization
YAKETY YAK SPEECH-LANGUAGE PATHOLOGISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LISA AUTENRIETH (OWNER)
(407) 201-8079
Entity
Organization
Contact information
Practice address
1717 FOX HOLLOW LN, YORK, SC 29745-9046
(407) 758-3624
Mailing address
1107 MABBETTE ST, KISSIMMEE, FL 34741-5161
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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