Provider Demographics
NPI:1811205776
Name:BOARDLEY, YVONNE SUZANNE
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:SUZANNE
Last Name:BOARDLEY
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 1:1 HOLLYBUSH GDNS
Mailing Address - Street 2:1
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-2326
Mailing Address - Country:US
Mailing Address - Phone:856-881-0737
Mailing Address - Fax:
Practice Address - Street 1:1 HOLLYBUSH GDNS
Practice Address - Street 2:1
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-2326
Practice Address - Country:US
Practice Address - Phone:856-881-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management