# YAKETY YAK SPEECH-LANGUAGE PATHOLOGISTS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003542374
- **Authorized official:** JENNIFER LISA AUTENRIETH (OWNER)
- **Authorized official phone:** (407) 201-8079

## Contact information

- **Practice address:** 1717 FOX HOLLOW LN, YORK, SC 29745-9046
- **Practice address phone:** (407) 758-3624
- **Mailing address:** 1107 MABBETTE ST, KISSIMMEE, FL 34741-5161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |

## Other

- **Enumeration date:** 07/28/2022
- **Last updated:** 07/28/2022