Provider Demographics
NPI:1376851857
Name:RAMOS-EDGERLY, YOLANDA RAQUEL (MS)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:RAQUEL
Last Name:RAMOS-EDGERLY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3026 BLUE CANYON TRL
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3516
Mailing Address - Country:US
Mailing Address - Phone:928-581-0047
Mailing Address - Fax:
Practice Address - Street 1:1 N WILLARD ST
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-3651
Practice Address - Country:US
Practice Address - Phone:928-634-2288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-19
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP6967235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist