Provider Demographics
NPI:1306210281
Name:STEPHENS, YOLANDA LOUI
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:LOUI
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:YOLANDA
Other - Middle Name:LOUI
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MT
Mailing Address - Street 1:20624 BALFOUR ST APT 1
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1522
Mailing Address - Country:US
Mailing Address - Phone:313-736-2070
Mailing Address - Fax:
Practice Address - Street 1:20624 BALFOUR ST APT 1
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-1522
Practice Address - Country:US
Practice Address - Phone:313-736-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501003289173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist