Provider Demographics
NPI:1235499195
Name:BURNITE, YOLANDA ANNE (RMT)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:ANNE
Last Name:BURNITE
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:MS
Other - First Name:ANDI
Other - Middle Name:ANNE
Other - Last Name:BURNITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RMT
Mailing Address - Street 1:PO BOX 1015
Mailing Address - Street 2:
Mailing Address - City:CRESTED BUTTE
Mailing Address - State:CO
Mailing Address - Zip Code:81224-1015
Mailing Address - Country:US
Mailing Address - Phone:970-596-0724
Mailing Address - Fax:
Practice Address - Street 1:120 ELK AVE.
Practice Address - Street 2:
Practice Address - City:CRESTED BUTTE
Practice Address - State:CO
Practice Address - Zip Code:81224
Practice Address - Country:US
Practice Address - Phone:970-596-0724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO633225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist