Provider Demographics
NPI:1568718963
Name:LLANOS, YAZMINA C (MA)
Entity Type:Individual
Prefix:
First Name:YAZMINA
Middle Name:C
Last Name:LLANOS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 WYNDCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-5945
Mailing Address - Country:US
Mailing Address - Phone:561-891-5908
Mailing Address - Fax:
Practice Address - Street 1:1242 WYNDCLIFF DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-5945
Practice Address - Country:US
Practice Address - Phone:561-891-5908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-03
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health