Provider Demographics
NPI:1043853104
Name:BUTLER, YOLONDA G (MHS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:YOLONDA
Middle Name:G
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MHS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 LAKE UNDERHILL RD STE 260
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4508
Mailing Address - Country:US
Mailing Address - Phone:407-249-3344
Mailing Address - Fax:407-378-2978
Practice Address - Street 1:12301 LAKE UNDERHILL RD STE 260
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4508
Practice Address - Country:US
Practice Address - Phone:407-249-3344
Practice Address - Fax:407-378-2978
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty