Provider Demographics
NPI:1154824886
Name:YAKUNINA, ELENA (PHD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:YAKUNINA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 336
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-0336
Mailing Address - Country:US
Mailing Address - Phone:716-535-6878
Mailing Address - Fax:
Practice Address - Street 1:1404 SWEET HOME RD STE 2
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2778
Practice Address - Country:US
Practice Address - Phone:716-535-6878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020781-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist