Provider Demographics
NPI:1760922215
Name:WHITE, YOLONDA KATRINA (EDD)
Entity Type:Individual
Prefix:MS
First Name:YOLONDA
Middle Name:KATRINA
Last Name:WHITE
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10426 STAFFORD CREEK CT APT 201
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-7297
Mailing Address - Country:US
Mailing Address - Phone:239-201-6249
Mailing Address - Fax:
Practice Address - Street 1:10426 STAFFORD CREEK CT APT 201
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-7297
Practice Address - Country:US
Practice Address - Phone:239-201-6249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL006323200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health