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Individual

YOLANDA BARDOUILLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
734 FULTON ST, BROOKLYN, NY 11238-1514
(718) 638-7356
Mailing address
734 FULTON ST, BROOKLYN, NY 11238-1514
(718) 638-7356

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
13-6400434
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
13-6400434
NY
Enumeration date
01/26/2017
Last updated
01/26/2017
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