Provider Demographics
NPI:1780227678
Name:DENT-YONKERS, GAY
Entity type:Individual
Prefix:
First Name:GAY
Middle Name:
Last Name:DENT-YONKERS
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 1:400 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8409
Mailing Address - Country:US
Mailing Address - Phone:330-562-1180
Mailing Address - Fax:
Practice Address - Street 1:400 KIMBERLY DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8409
Practice Address - Country:US
Practice Address - Phone:330-562-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-18-33516103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-18-33516OtherBEHAVIOR ANALYST