Provider Demographics
NPI:1336688209
Name:MEDINA ARENCIBIA, YENEY
Entity Type:Individual
Prefix:
First Name:YENEY
Middle Name:
Last Name:MEDINA ARENCIBIA
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 1:9016 COLLINS AVE
Mailing Address - Street 2:3
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-3259
Mailing Address - Country:US
Mailing Address - Phone:832-376-1734
Mailing Address - Fax:
Practice Address - Street 1:9016 COLLINS AVE
Practice Address - Street 2:3
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-3259
Practice Address - Country:US
Practice Address - Phone:832-376-1734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician