Provider Demographics
NPI:1508122144
Name:MEMPIN DUMDUMAYA, YOLANDA UBANDO
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:UBANDO
Last Name:MEMPIN DUMDUMAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 PALM ST UNIT 80
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-4709
Mailing Address - Country:US
Mailing Address - Phone:702-722-5321
Mailing Address - Fax:
Practice Address - Street 1:1624 PALM ST UNIT 80
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-4709
Practice Address - Country:US
Practice Address - Phone:702-722-5321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner