Provider Demographics
NPI:1336473883
Name:BOONE, YOLANDA YVONNE (MS)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:YVONNE
Last Name:BOONE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4875 TALL TREE LN
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-1548
Mailing Address - Country:US
Mailing Address - Phone:314-739-0649
Mailing Address - Fax:
Practice Address - Street 1:4875 TALL TREE LN
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-1548
Practice Address - Country:US
Practice Address - Phone:314-739-0649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009003429235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist