Provider Demographics
NPI:1609020767
Name:BRAILEY, YOLANDA (MA, LMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:
Last Name:BRAILEY
Suffix:
Gender:F
Credentials:MA, LMHC, NCC
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 341
Mailing Address - Street 2:
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-0341
Mailing Address - Country:US
Mailing Address - Phone:407-620-7855
Mailing Address - Fax:
Practice Address - Street 1:6200 METROWEST BLVD
Practice Address - Street 2:SUITE 201-H
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-7636
Practice Address - Country:US
Practice Address - Phone:407-620-7855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-15
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9639101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health