Individual
YVON SERGE DIMIYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA,MHA,MAPS
Contact information
Practice address
262 WOODWARD AVE, KENMORE, NY 14217-1539
(716) 566-7771
Mailing address
262 WOODWARD AVE, KENMORE, NY 14217-1539
(716) 566-7771
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NY
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/19/2019
Last updated
09/03/2020
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