Provider Demographics
NPI:1760029896
Name:DEMOSTHENEWOOD, YOLANDE
Entity Type:Individual
Prefix:
First Name:YOLANDE
Middle Name:
Last Name:DEMOSTHENEWOOD
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 1:3707 SILVER PARK DR APT 2043707
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2943
Mailing Address - Country:US
Mailing Address - Phone:202-749-1852
Mailing Address - Fax:
Practice Address - Street 1:3814 12TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2630
Practice Address - Country:US
Practice Address - Phone:202-656-9059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician