Provider Demographics
NPI:1124447867
Name:YAMBA, YEI
Entity type:Individual
Prefix:
First Name:YEI
Middle Name:
Last Name:YAMBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6876 RIVERDALE RD APT 332
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1066
Mailing Address - Country:US
Mailing Address - Phone:240-551-7560
Mailing Address - Fax:
Practice Address - Street 1:6876 RIVERDALE RD APT 332
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1066
Practice Address - Country:US
Practice Address - Phone:240-551-7560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA8917390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program