Provider Demographics
NPI:1467123182
Name:NAME ALMANZA, YEZMIN (LCPC-C)
Entity Type:Individual
Prefix:
First Name:YEZMIN
Middle Name:
Last Name:NAME ALMANZA
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-4038
Mailing Address - Country:US
Mailing Address - Phone:207-807-3230
Mailing Address - Fax:
Practice Address - Street 1:59 PINE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-4038
Practice Address - Country:US
Practice Address - Phone:207-807-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL6096101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health