Provider Demographics
NPI:1356503130
Name:RUIZ-TORRES, YAMILETTE (PHD)
Entity Type:Individual
Prefix:
First Name:YAMILETTE
Middle Name:
Last Name:RUIZ-TORRES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9809
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9809
Mailing Address - Country:US
Mailing Address - Phone:787-709-4130
Mailing Address - Fax:787-709-4134
Practice Address - Street 1:184 CALLE GUADALUPE FINAL
Practice Address - Street 2:ANTIGUO HOSPITAL SAN LUCAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00733
Practice Address - Country:US
Practice Address - Phone:787-709-4130
Practice Address - Fax:787-709-4134
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3045103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical