Individual
YALONDA EVON COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
219 FUQUAY SPRINGS AVE, FUQUAY VARINA, NC 27526-9332
(919) 567-9344
Mailing address
219 FUQUAY SPRINGS AVE, FUQUAY VARINA, NC 27526-9332
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL092560
NC
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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