Provider Demographics
NPI:1306662218
Name:ATABONG, YVETTE ALEMNGE
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:ALEMNGE
Last Name:ATABONG
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 1:9502 MUIRKIRK RD APT 201
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2751
Mailing Address - Country:US
Mailing Address - Phone:806-392-6735
Mailing Address - Fax:
Practice Address - Street 1:9502 MUIRKIRK RD APT 201
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2751
Practice Address - Country:US
Practice Address - Phone:806-392-6735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
TX890029163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101Y00000XBehavioral Health & Social Service ProvidersCounselor