Provider Demographics
NPI:1477755452
Name:YESU, DEBORAH A (PSYD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:YESU
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 1:28 ROSELAND TER
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1128
Mailing Address - Country:US
Mailing Address - Phone:413-567-3080
Mailing Address - Fax:
Practice Address - Street 1:35 POST OFFICE PARK STE 3504
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1186
Practice Address - Country:US
Practice Address - Phone:413-596-6922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7591103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent