Provider Demographics
NPI:1528787827
Name:GARTH, YULONDA MASHELL
Entity type:Individual
Prefix:
First Name:YULONDA
Middle Name:MASHELL
Last Name:GARTH
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 1:2288 GUNBARREL RD STE 154
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3492
Mailing Address - Country:US
Mailing Address - Phone:423-482-8497
Mailing Address - Fax:
Practice Address - Street 1:521 MEADOWLARK TRL
Practice Address - Street 2:
Practice Address - City:EAST RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37412-4170
Practice Address - Country:US
Practice Address - Phone:423-240-8914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional