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General NPI Number Information
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NPI Number | 1336109487
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Entity Type | Individual
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Provider Name | YOLANDA MARY VILLENA PHD
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 829 PRESIDENT STREET
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City | BROOKLYN
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State | NY
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Zip | 11215-1405
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Country | US
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Telephone | 718-638-8015
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Fax | 718-230-0464
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Provider Business Mailing Address
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Address Line | 182 ST JOHNS PLACE
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City | BROOKLYN
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State | NY
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Zip | 11217-3402
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Country | US
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Telephone | 917-612-8307
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Fax | 718-230-0464
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 012012
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License Number State | NY
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