Provider Demographics
NPI:1619040565
Name:COLE, YOLANDA JONES (MSE-CCC)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:JONES
Last Name:COLE
Suffix:
Gender:F
Credentials:MSE-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W BLOOMINGDALE AVE
Mailing Address - Street 2:H
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7444
Mailing Address - Country:US
Mailing Address - Phone:813-662-1106
Mailing Address - Fax:813-661-7661
Practice Address - Street 1:605 W BLOOMINGDALE AVE
Practice Address - Street 2:H
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7444
Practice Address - Country:US
Practice Address - Phone:813-662-1106
Practice Address - Fax:813-661-7661
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist