Provider Demographics
NPI:1457793804
Name:RIDDLE, YOLANDA (MAPC)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:RIDDLE
Suffix:
Gender:F
Credentials:MAPC
Other - Prefix:MRS
Other - First Name:YOLANDA
Other - Middle Name:
Other - Last Name:RIDDLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MAPC
Mailing Address - Street 1:5418 SPAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-5247
Mailing Address - Country:US
Mailing Address - Phone:504-909-2512
Mailing Address - Fax:
Practice Address - Street 1:4323 DIVISION ST STE 110
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3179
Practice Address - Country:US
Practice Address - Phone:504-883-8330
Practice Address - Fax:504-273-1513
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1457793804Medicaid