Provider Demographics
NPI:1326521360
Name:KOLO, YOVONDA (PHD)
Entity Type:Individual
Prefix:
First Name:YOVONDA
Middle Name:
Last Name:KOLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10816 TOWN CENTER BLVD # 618
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-2708
Mailing Address - Country:US
Mailing Address - Phone:301-332-6249
Mailing Address - Fax:
Practice Address - Street 1:184 GREENFIELD CRES
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4879
Practice Address - Country:US
Practice Address - Phone:301-332-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health