Provider Demographics
NPI:1538204490
Name:PHILLIPS, YOLANDA PAMELA (MSCACAD)
Entity type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:PAMELA
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MSCACAD
Other - Prefix:
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Mailing Address - Street 1:2911 N ROGERS AVE
Mailing Address - Street 2:9100 FRANKLIN SQUARE DRIVE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-6772
Mailing Address - Country:US
Mailing Address - Phone:410-887-7671
Mailing Address - Fax:410-687-6005
Practice Address - Street 1:9100 FRANKLIN SQUARE DR
Practice Address - Street 2:9100 FRANKLIN SQUARE DRIVE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3903
Practice Address - Country:US
Practice Address - Phone:410-887-7671
Practice Address - Fax:410-687-6005
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDAC0035101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)