Individual
MS. NICOLE JENNIFER YAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHC
Contact information
Practice address
WAYNE BEHAVIORAL HEATLH NETWORK, 1519 NYE ROAD, LYONS, NY 14489
(315) 946-5722
(315) 946-7066
Mailing address
1692 RIDGE RD, ONTARIO, NJ 14519
(315) 524-2686
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
P54282
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02249154
—
NY
Enumeration date
03/12/2007
Last updated
07/08/2007
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