Provider Demographics
NPI:1114678174
Name:BUILES, YEIRA (HEALTH COACH)
Entity Type:Individual
Prefix:
First Name:YEIRA
Middle Name:
Last Name:BUILES
Suffix:
Gender:F
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3202
Mailing Address - Country:US
Mailing Address - Phone:203-253-3698
Mailing Address - Fax:
Practice Address - Street 1:125 CLARK ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3202
Practice Address - Country:US
Practice Address - Phone:203-253-3698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT