Provider Demographics
NPI:1881180099
Name:SMITH, YOLONDA YVETTE
Entity type:Individual
Prefix:MRS
First Name:YOLONDA
Middle Name:YVETTE
Last Name:SMITH
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 1:7749 SHADY WATER LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-3688
Mailing Address - Country:US
Mailing Address - Phone:937-329-1642
Mailing Address - Fax:
Practice Address - Street 1:7749 SHADY WATER LN
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3688
Practice Address - Country:US
Practice Address - Phone:937-329-1642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No253Z00000XAgenciesIn Home Supportive Care
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1326012360OtherAGENCY NPI