Provider Demographics
NPI:1568240752
Name:DENIS, YANICK REBECCA
Entity Type:Individual
Prefix:
First Name:YANICK
Middle Name:REBECCA
Last Name:DENIS
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 1:72 E CONCORD ST RM 704
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2640
Mailing Address - Country:US
Mailing Address - Phone:617-414-1644
Mailing Address - Fax:
Practice Address - Street 1:72 E CONCORD ST RM 704
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2640
Practice Address - Country:US
Practice Address - Phone:617-414-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator