Provider Demographics
NPI:1568731123
Name:WILLIAMS, YOLANDA W (RD)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:W
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75633-0829
Mailing Address - Country:US
Mailing Address - Phone:903-235-8578
Mailing Address - Fax:903-694-9191
Practice Address - Street 1:1315 SPRING ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TX
Practice Address - Zip Code:75633-2061
Practice Address - Country:US
Practice Address - Phone:903-694-9191
Practice Address - Fax:903-694-9191
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81953133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic