Provider Demographics
NPI:1245968809
Name:CORCORAN, YVONNE MARIE (MS, BCBA, LABA)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:MARIE
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:MS, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 PINE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3635
Mailing Address - Country:US
Mailing Address - Phone:978-717-5062
Mailing Address - Fax:
Practice Address - Street 1:83 PINE ST STE 102
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-3635
Practice Address - Country:US
Practice Address - Phone:978-717-5062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst