Provider Demographics
NPI:1215169537
Name:POHL, YOLANDA CHARLENE (BA)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:CHARLENE
Last Name:POHL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 MARBLE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2058
Mailing Address - Country:US
Mailing Address - Phone:505-272-1859
Mailing Address - Fax:505-272-1254
Practice Address - Street 1:2600 MARBLE AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2058
Practice Address - Country:US
Practice Address - Phone:505-272-1859
Practice Address - Fax:505-272-1254
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1215169537OtherNNPES
NM897401OtherUNIVERSITY OF NEW MEXICO PSYCHIATRIC CENTER