Provider Demographics
NPI:1164093811
Name:FELIX, YAJAIRA (PSYMA)
Entity Type:Individual
Prefix:MS
First Name:YAJAIRA
Middle Name:
Last Name:FELIX
Suffix:
Gender:F
Credentials:PSYMA
Other - Prefix:MS
Other - First Name:YAJAIRA
Other - Middle Name:
Other - Last Name:FELIX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYMA
Mailing Address - Street 1:PO BOX 30056
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-1056
Mailing Address - Country:US
Mailing Address - Phone:787-461-6955
Mailing Address - Fax:
Practice Address - Street 1:495A CALLE 27
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-1217
Practice Address - Country:US
Practice Address - Phone:787-754-5087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6773103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling