Provider Demographics
NPI:1306192133
Name:WALCOTT, YOLANDA C (DBS)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:C
Last Name:WALCOTT
Suffix:
Gender:F
Credentials:DBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 ARROWHEAD BLVD
Mailing Address - Street 2:A-2
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-1169
Mailing Address - Country:US
Mailing Address - Phone:678-472-2281
Mailing Address - Fax:
Practice Address - Street 1:217 ARROWHEAD BLVD
Practice Address - Street 2:A-2
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1169
Practice Address - Country:US
Practice Address - Phone:678-472-2281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA09085537170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS