Provider Demographics
NPI:1659977593
Name:LORENZO, YAILEEN (MWS)
Entity Type:Individual
Prefix:
First Name:YAILEEN
Middle Name:
Last Name:LORENZO
Suffix:
Gender:F
Credentials:MWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 60 BOX 12652
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9263
Mailing Address - Country:US
Mailing Address - Phone:787-566-7375
Mailing Address - Fax:
Practice Address - Street 1:MOCA PROFESSIONAL PLAZA PR111 INT PR 110 KM 14.5
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-641-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR136951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical