Provider Demographics
NPI:1073080438
Name:PREVOST, YOLANDA
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:PREVOST
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 1:5630 CROWDER BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-2444
Mailing Address - Country:US
Mailing Address - Phone:504-495-7761
Mailing Address - Fax:
Practice Address - Street 1:5630 CROWDER BLVD STE 208
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-2444
Practice Address - Country:US
Practice Address - Phone:504-241-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator