Healthcare Provider Details

I. General information

NPI: 1023363439
Provider Name (Legal Business Name): YOLAINE COTEL L.M.H.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2012
Last Update Date: 09/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 CHILDRENS WAY
ENTERPRISE FL
32725-8135
US

IV. Provider business mailing address

51 CHILDREN'S WAY
ENTERPRISE FLORIDA
32725
UM

V. Phone/Fax

Practice location:
  • Phone: 386-668-4774
  • Fax: 386-668-0542
Mailing address:
  • Phone: 386-668-4774
  • Fax: 386-668-0542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8012
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: