Provider Demographics
NPI:1255691762
Name:BOLAND, YVETTE RAMIREZ (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:RAMIREZ
Last Name:BOLAND
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7512 HARPERS CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8684
Mailing Address - Country:US
Mailing Address - Phone:336-766-4981
Mailing Address - Fax:
Practice Address - Street 1:8800 BUCKEY CT
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27023-7745
Practice Address - Country:US
Practice Address - Phone:336-946-2493
Practice Address - Fax:336-450-2637
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9930235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist