Provider Demographics
NPI:1760060396
Name:MARRERO PAGAN, YARELIS (MPSYC COUNSELING PSY)
Entity Type:Individual
Prefix:
First Name:YARELIS
Middle Name:
Last Name:MARRERO PAGAN
Suffix:
Gender:F
Credentials:MPSYC COUNSELING PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 10195
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-9640
Mailing Address - Country:US
Mailing Address - Phone:787-615-0304
Mailing Address - Fax:
Practice Address - Street 1:CARR 725 KM 2.4
Practice Address - Street 2:BO. LLANOS
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-615-0304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6822103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling