Provider Demographics
NPI:1083346167
Name:MARCELLE, YAASMIYN S
Entity Type:Individual
Prefix:MRS
First Name:YAASMIYN
Middle Name:S
Last Name:MARCELLE
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 1:10939 LIVERPOOL ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-5729
Mailing Address - Country:US
Mailing Address - Phone:347-830-5680
Mailing Address - Fax:
Practice Address - Street 1:10939 LIVERPOOL ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-5729
Practice Address - Country:US
Practice Address - Phone:347-830-5680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health