Individual
YOLANDA LORRAINE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1930 N CARROLL AVE APT 509, DALLAS, TX 75204-8831
(972) 834-8768
Mailing address
1930 N CARROLL AVE APT 509, DALLAS, TX 75204-8831
(972) 834-8768
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
50272-0122
TX
174400000X
Specialist
50423-0322
TX
174400000X
Specialist
—
—
175T00000X
Peer Specialist
50272-0122
TX
175T00000X
Peer Specialist
Primary
50423-0322
TX
Other
Enumeration date
03/18/2024
Last updated
04/04/2024
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