Provider Demographics
NPI:1437360617
Name:YUKNEWICZ-BOISVERT, DEBORAH (M ED)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:YUKNEWICZ-BOISVERT
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CROSBY RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4370
Mailing Address - Country:US
Mailing Address - Phone:603-749-4015
Mailing Address - Fax:
Practice Address - Street 1:50 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3308
Practice Address - Country:US
Practice Address - Phone:603-749-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30931444Medicaid
NHRE6496Medicare ID - Type Unspecified