Provider Demographics
NPI:1467885772
Name:REY, YOLANDA (11726)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:REY
Suffix:
Gender:F
Credentials:11726
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 CALLE ANDALUCIA
Mailing Address - Street 2:CIUDAD REAL
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3672
Mailing Address - Country:US
Mailing Address - Phone:787-345-6324
Mailing Address - Fax:
Practice Address - Street 1:566 CALLE ANDALUCIA
Practice Address - Street 2:CIUDAD REAL
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3672
Practice Address - Country:US
Practice Address - Phone:787-345-6324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-10
Last Update Date:2013-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11726174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11726OtherMASTER CLINIC SOCIAL WORK