Provider Demographics
NPI:1164937041
Name:O'CONNOR, YVONNE MARY (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:MARY
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 DEPOT RD
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-3345
Mailing Address - Country:US
Mailing Address - Phone:508-237-5606
Mailing Address - Fax:
Practice Address - Street 1:89 DEPOT RD
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-3345
Practice Address - Country:US
Practice Address - Phone:508-237-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1851103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst