Provider Demographics
NPI:1346659497
Name:BEATTY, YOLONDA TIA (SLPD)
Entity type:Individual
Prefix:DR
First Name:YOLONDA
Middle Name:TIA
Last Name:BEATTY
Suffix:
Gender:F
Credentials:SLPD
Other - Prefix:
Other - First Name:YOLONDA
Other - Middle Name:TIA
Other - Last Name:HODGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 JEFFREY CT SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0075
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1025 JEFFREY CT SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0075
Practice Address - Country:US
Practice Address - Phone:919-539-4807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10940235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist