Provider Demographics
NPI:1760881767
Name:MARCANO, YARITZA (MA)
Entity Type:Individual
Prefix:MRS
First Name:YARITZA
Middle Name:
Last Name:MARCANO
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:L-21 CALLE 9
Mailing Address - Street 2:URB. REINA DE LOS ANGELES
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-599-8174
Mailing Address - Fax:
Practice Address - Street 1:L21 CALLE 9 W
Practice Address - Street 2:URB. REINA DE LOS ANGELES
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-4046
Practice Address - Country:US
Practice Address - Phone:787-599-8174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4288103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling