Provider Demographics
NPI:1548593411
Name:YUKNAT, MARCY KERR (PSYD)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:KERR
Last Name:YUKNAT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 HARTFORD STEET
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02030
Mailing Address - Country:US
Mailing Address - Phone:508-785-3021
Mailing Address - Fax:
Practice Address - Street 1:143 NEWBURY ST FL 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2925
Practice Address - Country:US
Practice Address - Phone:617-396-4785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9928103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical