Provider Demographics
NPI:1962836486
Name:GOLPHIN, YALANDA LAVETTE (LCC)
Entity Type:Individual
Prefix:DR
First Name:YALANDA
Middle Name:LAVETTE
Last Name:GOLPHIN
Suffix:
Gender:F
Credentials:LCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 FERN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-6619
Mailing Address - Country:US
Mailing Address - Phone:678-984-6194
Mailing Address - Fax:
Practice Address - Street 1:2745 FERN VALLEY DR
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-6619
Practice Address - Country:US
Practice Address - Phone:678-984-6194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist