Provider Demographics
NPI:1861081358
Name:BROWN-SPIDELL, YOLANDA (MA)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:BROWN-SPIDELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37160 S WOODBRIDGE CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-4577
Mailing Address - Country:US
Mailing Address - Phone:313-469-4132
Mailing Address - Fax:
Practice Address - Street 1:37160 S WOODBRIDGE CIR APT 202
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-4577
Practice Address - Country:US
Practice Address - Phone:313-469-4132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISA0000000864904174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator