Provider Demographics
NPI:1194149948
Name:DUROSEAU, YVENER
Entity type:Individual
Prefix:MR
First Name:YVENER
Middle Name:
Last Name:DUROSEAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 S YORKTOWN AVE
Mailing Address - Street 2:# 745
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74170-3401
Mailing Address - Country:US
Mailing Address - Phone:617-735-5228
Mailing Address - Fax:
Practice Address - Street 1:6910 S YORKTOWN AVE
Practice Address - Street 2:# 745
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74170-3401
Practice Address - Country:US
Practice Address - Phone:617-735-5228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-14
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health