Provider Demographics
NPI:1124823653
Name:SMITH, YOLANDA M
Entity type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:M
Last Name:SMITH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 CRANBERRY RUN DR
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2501
Mailing Address - Country:US
Mailing Address - Phone:440-694-5821
Mailing Address - Fax:
Practice Address - Street 1:388 CRANBERRY RUN DR
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-2501
Practice Address - Country:US
Practice Address - Phone:440-694-5821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRU843584343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)