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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
MS. JENNIFER AUTENRIETH M.A. CCC-SLP (SPEECH PATHOLOGIST, PRESIDENT)
(407) 201-8079
Entity
Organization
Contact information
Practice address
1107 MABBETTE ST, KISSIMMEE, FL 34741-5161
(407) 201-8079
(407) 343-9180
Mailing address
1107 MABBETTE ST, KISSIMMEE, FL 34741-5161
(407) 201-8079
(407) 343-9180
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
FL
225100000X
Physical Therapist
—
FL
225X00000X
Occupational Therapist
—
FL
2355S0801X
Speech-Language Assistant
—
FL
235Z00000X
Speech-Language Pathologist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890635100
—
FL
Enumeration date
03/18/2010
Last updated
10/17/2016
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