Provider Demographics
NPI:1104179472
Name:YOUDEN, DOREEN PATRICIA
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:PATRICIA
Last Name:YOUDEN
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 1:278 GOLDSMITH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-5908
Mailing Address - Country:US
Mailing Address - Phone:978-337-0198
Mailing Address - Fax:
Practice Address - Street 1:278 GOLDSMITH ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-5908
Practice Address - Country:US
Practice Address - Phone:978-337-0198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst