Provider Demographics
NPI:1740685502
Name:ROBB, YAHNIQUE
Entity type:Individual
Prefix:
First Name:YAHNIQUE
Middle Name:
Last Name:ROBB
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 1:67 FRANK ST
Mailing Address - Street 2:APT 194
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1072
Mailing Address - Country:US
Mailing Address - Phone:508-579-8714
Mailing Address - Fax:
Practice Address - Street 1:1280 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-1801
Practice Address - Country:US
Practice Address - Phone:508-754-1141
Practice Address - Fax:508-754-1115
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst