Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1016 | OK |
N | 103T00000X | Psychologist | 1016 | OK |
Y | 102L00000X | Psychologist | 1230 | KS |
Y | 103T00000X | Psychologist | 1230 | KS |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1016 | OK |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1230 | KS |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1016 | OK |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1230 | KS |
N | 103TM1800X | Intellectual & Developmental Disabilities | 1016 | OK |
N | 103TM1800X | Intellectual & Developmental Disabilities | 1230 | KS |
N | 103TP2701X | Group Psychotherapist | 1016 | OK |
N | 103TP2701X | Group Psychotherapist | 1230 | KS |
N | 103TS0200X | School Psychologist | 1016 | OK |
N | 103TS0200X | School Psychologist | 1230 | KS |
NPI | 1134490444 |
---|---|
Provider Name | Dr. Georgette Yetter |
First Address | Manhattan, KS 66503-2566 |
Second Address | Manhattan, KS 66503-3159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2012 |
Last Update Date | 30/06/2020 |