Provider Demographics
NPI:1700191772
Name:ESPIN SALAZAR, YANIRA (MS)
Entity Type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:ESPIN SALAZAR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 WILES RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2063
Mailing Address - Country:US
Mailing Address - Phone:772-249-4463
Mailing Address - Fax:772-249-4471
Practice Address - Street 1:1511 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5478
Practice Address - Country:US
Practice Address - Phone:772-249-4463
Practice Address - Fax:772-249-4471
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 7909101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIMH 7909OtherREGISTERED MENTAL HEALTH COUNSELOR INTERN