Individual
MRS. SUSAN E YEATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
145 JACQUELINE DR, MANCHESTER, CT 06040-7071
(860) 645-0867
Mailing address
145 JACQUELINE DR, MANCHESTER, CT 06040-7071
(860) 645-0867
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
002139
CT
235Z00000X
Speech-Language Pathologist
1238
NH
235Z00000X
Speech-Language Pathologist
41YS00566800
NJ
235Z00000X
Speech-Language Pathologist
5265
MA
Other
Enumeration date
11/25/2012
Last updated
11/25/2012
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