Provider Demographics
NPI:1255537452
Name:RAWLS, YOLANDA MICHELLE (SLP-A)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:MICHELLE
Last Name:RAWLS
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:MICHELLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7912 MABELVALE PIKE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-3353
Mailing Address - Country:US
Mailing Address - Phone:501-570-0904
Mailing Address - Fax:501-570-0904
Practice Address - Street 1:7912 MABELVALE PIKE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-3353
Practice Address - Country:US
Practice Address - Phone:501-570-0904
Practice Address - Fax:501-570-0904
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR#10-0022355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR176258721OtherMEDICAID PROVIDER NO.