Basic Information
| Provider Information | |||||||||
| NPI: | 1861702482 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRIERSON | ||||||||
| FirstName: | YOULANDA | ||||||||
| MiddleName: | LASHANDA | ||||||||
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| Credential: | BSW, MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2741 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292022741 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037084712 | ||||||||
| FaxNumber: | 8037084718 | ||||||||
| Practice Location | |||||||||
| Address1: | 325 SHAGBARK AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292094448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8036950621 | ||||||||
| FaxNumber: | 8037084718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2010 | ||||||||
| LastUpdateDate: | 10/19/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.