Provider Demographics
NPI:1881200319
Name:PEARSON, YOLANDA V
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:V
Last Name:PEARSON
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 1:103 CANEY BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-7217
Mailing Address - Country:US
Mailing Address - Phone:202-440-1527
Mailing Address - Fax:
Practice Address - Street 1:103 CANEY BRANCH RD
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-7217
Practice Address - Country:US
Practice Address - Phone:202-440-1527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT69003405171WV0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WV0202XOther Service ProvidersContractorVehicle Modifications