Provider Demographics
NPI:1902900145
Name:NALL, YOLANDA (LCSW)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:NALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:
Other - Last Name:NALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3731 KINDLE LN
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-9102
Mailing Address - Country:US
Mailing Address - Phone:405-388-8393
Mailing Address - Fax:
Practice Address - Street 1:4301 MOW-WAY ROAD
Practice Address - Street 2:REYNOLD'S ARMY COMMUNITY HOSPITAL (ATTN MS PRESCOTT
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503
Practice Address - Country:US
Practice Address - Phone:580-458-2134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2744101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health