Healthcare Provider Details

I. General information

NPI: 1073943395
Provider Name (Legal Business Name): YOLONDA MASON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2013
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 THORNLESS ROSE CT
LAS VEGAS NV
89183-5570
US

IV. Provider business mailing address

1055 E FLAMINGO RD APT 215
LAS VEGAS NV
89119-7442
US

V. Phone/Fax

Practice location:
  • Phone: 404-988-3980
  • Fax:
Mailing address:
  • Phone: 702-505-1503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number36918-AL-4
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: