Provider Demographics
NPI:1336801448
Name:BADY, YEMALICIA DOROSA
Entity Type:Individual
Prefix:
First Name:YEMALICIA
Middle Name:DOROSA
Last Name:BADY
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 1:80 PRINCETON ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-4837
Mailing Address - Country:US
Mailing Address - Phone:917-495-2247
Mailing Address - Fax:
Practice Address - Street 1:80 PRINCETON ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-4837
Practice Address - Country:US
Practice Address - Phone:917-495-2247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor