Provider Demographics
NPI:1114340551
Name:Y. D.L.P MIND AND WELLNESS SERVICES INC.
Entity Type:Organization
Organization Name:Y. D.L.P MIND AND WELLNESS SERVICES INC.
Other - Org Name:Y.D.L.P MIND AND WELLNESS SERVICES INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:YOHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA PRIDA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-720-6163
Mailing Address - Street 1:7102 SW 103RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1377
Mailing Address - Country:US
Mailing Address - Phone:305-720-6163
Mailing Address - Fax:
Practice Address - Street 1:2081 W 76TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1834
Practice Address - Country:US
Practice Address - Phone:305-720-6163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6881174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty