Provider Demographics
NPI:1447806138
Name:HAYDEN, YOLANDA DIANA (LGPC)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:DIANA
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 COLLEGE PKWY APT 102
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1128
Mailing Address - Country:US
Mailing Address - Phone:301-710-3670
Mailing Address - Fax:
Practice Address - Street 1:470 COLLEGE PKWY APT 102
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1128
Practice Address - Country:US
Practice Address - Phone:301-710-3670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-18
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9790101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health