Provider Demographics
NPI:1548998024
Name:YEAGER, BRYNN
Entity type:Individual
Prefix:
First Name:BRYNN
Middle Name:
Last Name:YEAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4621 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-2916
Mailing Address - Country:US
Mailing Address - Phone:865-368-1563
Mailing Address - Fax:
Practice Address - Street 1:118 MABRY HOOD RD STE 400
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2219
Practice Address - Country:US
Practice Address - Phone:865-982-5225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13563101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor