Provider Demographics
NPI:1558795575
Name:CUADRA, YAELIE (MSW)
Entity Type:Individual
Prefix:
First Name:YAELIE
Middle Name:
Last Name:CUADRA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE CANOABO #42
Mailing Address - Street 2:CIUDAD JARDIN DE JUNCOS
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-0758
Mailing Address - Country:US
Mailing Address - Phone:787-675-7759
Mailing Address - Fax:
Practice Address - Street 1:214 CALLE MAYAGUEZ
Practice Address - Street 2:INTERIOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5104
Practice Address - Country:US
Practice Address - Phone:787-675-7759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5431103T00000X
PR9936104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103T00000XBehavioral Health & Social Service ProvidersPsychologist