Provider Demographics
NPI:1043714736
Name:VALDOUIN, EMMANUELA YOLA
Entity Type:Individual
Prefix:
First Name:EMMANUELA
Middle Name:YOLA
Last Name:VALDOUIN
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 1:6 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:MA
Mailing Address - Zip Code:02343-2017
Mailing Address - Country:US
Mailing Address - Phone:617-416-3524
Mailing Address - Fax:
Practice Address - Street 1:6 SPRING ST
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:MA
Practice Address - Zip Code:02343-2017
Practice Address - Country:US
Practice Address - Phone:617-416-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst