Doctor Name: | SUELEN D. YANCOR |
NPI Number: | 1063621811 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.W. |
License Number: | |
Business Practice Address: | 317 Blue Hill Ave Dorchester, MA - 021214302 |
Business Phone Number: | 6174274470 |
Business Fax Number: | 6174429419 |
Mailing Address: | 21 Avon St # 1, SOMERVILLE |
State: | MA |
Postal Code: | 021431601 |
Phone Number: | 6174274470 |
Fax Number: | 6174429419 |
NPI Enumeration Date: | 05/21/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |