Provider Demographics
NPI:1700595899
Name:REED-NOLAN, YINKA (LAC)
Entity Type:Individual
Prefix:
First Name:YINKA
Middle Name:
Last Name:REED-NOLAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6727 E VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-3227
Mailing Address - Country:US
Mailing Address - Phone:510-866-3489
Mailing Address - Fax:
Practice Address - Street 1:6700 N ORACLE RD STE 505
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7736
Practice Address - Country:US
Practice Address - Phone:520-330-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-19895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health