Provider Demographics
NPI:1881036648
Name:PACKER, YALONDA SENIECE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:YALONDA
Middle Name:SENIECE
Last Name:PACKER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 BRAEMAR HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-6728
Mailing Address - Country:US
Mailing Address - Phone:910-305-6469
Mailing Address - Fax:919-551-7588
Practice Address - Street 1:1209 BRAEMAR HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-6728
Practice Address - Country:US
Practice Address - Phone:910-305-6469
Practice Address - Fax:919-551-7588
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10427235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist