Provider Demographics
NPI:1639858533
Name:GUZMAN RIVERA, YELINEE M
Entity Type:Individual
Prefix:
First Name:YELINEE
Middle Name:M
Last Name:GUZMAN RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 EAGLE ROCK AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2138
Mailing Address - Country:US
Mailing Address - Phone:888-284-2034
Mailing Address - Fax:
Practice Address - Street 1:659 EAGLE ROCK AVE STE 4
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2138
Practice Address - Country:US
Practice Address - Phone:888-284-2034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health