Provider Demographics
NPI:1558398636
Name:WASHINGTON, YOLONDA G (OTR/L)
Entity Type:Individual
Prefix:
First Name:YOLONDA
Middle Name:G
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6885 GORDON EVANS RD
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-9710
Mailing Address - Country:US
Mailing Address - Phone:850-939-4725
Mailing Address - Fax:
Practice Address - Street 1:6885 GORDON EVANS RD
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-9710
Practice Address - Country:US
Practice Address - Phone:850-939-4725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT2855225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88547000Medicaid
FLOT2855OtherFL OCCUPATIONAL THERAPY