Provider Demographics
NPI:1629131032
Name:RAMBIN, YOLANDA R (PHD, MPAP)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:R
Last Name:RAMBIN
Suffix:
Gender:F
Credentials:PHD, MPAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 W SHAMROCK AVE
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-6439
Mailing Address - Country:US
Mailing Address - Phone:318-484-6850
Mailing Address - Fax:318-484-6232
Practice Address - Street 1:242 W SHAMROCK
Practice Address - Street 2:UNIT 1
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-6439
Practice Address - Country:US
Practice Address - Phone:318-484-6850
Practice Address - Fax:318-484-6232
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA539103TC0700X
LAMPAP.000043103TP0016X
LAMP.000539103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1914061Medicaid
LA1914061Medicaid