Provider Demographics
NPI:1912142472
Name:CLARKE ANDREWS, YVONNE A
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:A
Last Name:CLARKE ANDREWS
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 1:176 LONGMEADOW DR APT 111
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:MA
Mailing Address - Zip Code:02343-2222
Mailing Address - Country:US
Mailing Address - Phone:857-991-4126
Mailing Address - Fax:781-885-2632
Practice Address - Street 1:90 CUSHING AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-2028
Practice Address - Country:US
Practice Address - Phone:617-379-3306
Practice Address - Fax:617-379-3315
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program