Provider Demographics
NPI:1770088700
Name:YANNONE, KRISTA
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:YANNONE
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 1:137 BUSSEY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2231
Mailing Address - Country:US
Mailing Address - Phone:508-208-9515
Mailing Address - Fax:
Practice Address - Street 1:137 BUSSEY ST APT 2
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2231
Practice Address - Country:US
Practice Address - Phone:508-208-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst