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NPI Code Detail

MEDICARE: MIA YOLANDA NANCE

MEDICARE:   MIA YOLANDA NANCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1134658313
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA YOLANDA NANCE
Provider Business Mailing Address
First Line : 6315 WATERFORD HILLS DR APT 1223
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-3137
Country : US
Telephone Number : 704-293-8061
Fax Number :
Provider Business Practice Location Address
First Line : 6315 WATERFORD HILLS DR APT 1223
Second Line :
City : CHARLOTTE
State : NC
Zip : 28269-3137
Country : US
Telephone Number : 704-293-8061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2017
Last Update Date : 06/09/2017

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Directions to “ MIA YOLANDA NANCE ” Practice Location

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