Provider Demographics
NPI:1003149592
Name:GUADIANA, YOLANDA (LMT)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:GUADIANA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 NE LOOP 410
Mailing Address - Street 2:SUITE 214
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5829
Mailing Address - Country:US
Mailing Address - Phone:210-375-4408
Mailing Address - Fax:866-381-5557
Practice Address - Street 1:85 NE LOOP 410
Practice Address - Street 2:SUITE 214
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5829
Practice Address - Country:US
Practice Address - Phone:210-375-4408
Practice Address - Fax:866-381-5557
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXMT 038034225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist