Provider Demographics
NPI:1629785076
Name:JEAN BAPTISTE-MATILUS, YOLNIE
Entity Type:Individual
Prefix:
First Name:YOLNIE
Middle Name:
Last Name:JEAN BAPTISTE-MATILUS
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 1:198 ARORA BLVD APT 2007
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-3283
Mailing Address - Country:US
Mailing Address - Phone:954-665-0597
Mailing Address - Fax:
Practice Address - Street 1:198 ARORA BLVD APT 2007
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-3283
Practice Address - Country:US
Practice Address - Phone:954-665-0597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty