Provider Demographics
NPI:1043097181
Name:ANTOINE, NEYDIE
Entity type:Individual
Prefix:
First Name:NEYDIE
Middle Name:
Last Name:ANTOINE
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 1:52 MAIN ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3358
Mailing Address - Country:US
Mailing Address - Phone:754-551-4698
Mailing Address - Fax:
Practice Address - Street 1:350 CROSS ST APT 1A
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-7917
Practice Address - Country:US
Practice Address - Phone:754-551-4698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor