Individual
KIM LYNETTE YEAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8206 BARKSDALE WAY, INDIANAPOLIS, IN 46216-2085
(317) 546-3050
Mailing address
8206 BARKSDALE WAY, INDIANAPOLIS, IN 46216-2085
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001387A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530A
—
IN
Enumeration date
03/23/2007
Last updated
11/13/2020
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