Provider Demographics
NPI:1174725592
Name:BERTRAND, YOLANDA JAVN (LPTA)
Entity type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:JAVN
Last Name:BERTRAND
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 DEERLICK LN
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2211
Mailing Address - Country:US
Mailing Address - Phone:504-340-3033
Mailing Address - Fax:
Practice Address - Street 1:2328 DEERLICK LN
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2211
Practice Address - Country:US
Practice Address - Phone:504-340-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA4945225200000X
TX2057757225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant