Provider Demographics
NPI:1073812814
Name:DAMIAN, YAHAIRA
Entity Type:Individual
Prefix:
First Name:YAHAIRA
Middle Name:
Last Name:DAMIAN
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 1:1423 HEATHER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-1570
Mailing Address - Country:US
Mailing Address - Phone:323-542-7937
Mailing Address - Fax:
Practice Address - Street 1:1423 HEATHER RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031
Practice Address - Country:US
Practice Address - Phone:323-542-7937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst