Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY0002704 | FL |
Y | 103TC0700X | Clinical Psychologist | PY0002704 | FL |
NPI | 1013137744 |
---|---|
Provider Name | Stephen I. Yaeger |
First Address | Coral Gables, FL 33146-3043 |
Second Address | Coral Gables, FL 33146-3043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |