Provider Demographics
NPI:1356796221
Name:CARROLL, YOYANDA
Entity type:Individual
Prefix:
First Name:YOYANDA
Middle Name:
Last Name:CARROLL
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 1:2319 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-3405
Mailing Address - Country:US
Mailing Address - Phone:318-426-7255
Mailing Address - Fax:866-625-8448
Practice Address - Street 1:317 SMITH REED RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2605
Practice Address - Country:US
Practice Address - Phone:888-988-9848
Practice Address - Fax:866-625-8448
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic