Provider Demographics
NPI:1275399867
Name:NEIL, YASMIN REGINA
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:REGINA
Last Name:NEIL
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 1:14 LAFAYETTE SQ STE 2300
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1923
Mailing Address - Country:US
Mailing Address - Phone:716-302-4545
Mailing Address - Fax:
Practice Address - Street 1:14 LAFAYETTE SQ STE 2300
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1923
Practice Address - Country:US
Practice Address - Phone:716-302-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP1269981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical