Organization
GARY D YEAST
Active
Other names
Marital and Family Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY DON YEAST (CLINICAL DIRECTOR)
(715) 842-3913
Entity
Organization
Contact information
Practice address
301 EAST KENT STREET, WAUSAU, WI 54403
(715) 842-3913
(715) 842-0092
Mailing address
PO BOX 615, WAUSAU, WI 54402-0615
(715) 842-3913
(715) 842-0092
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1040872
CIGNA BEHAVIORAL HEALTH
—
01
—
130492
VALUE OPTIONS
—
Enumeration date
11/28/2006
Last updated
08/22/2020
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