Provider Demographics
NPI:1932696887
Name:RODRIGUEZ MORALES, YOLIMAR YARIS (MS, SLP)
Entity Type:Individual
Prefix:MRS
First Name:YOLIMAR
Middle Name:YARIS
Last Name:RODRIGUEZ MORALES
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-0580
Mailing Address - Country:US
Mailing Address - Phone:787-404-6196
Mailing Address - Fax:
Practice Address - Street 1:JR-3 URB. LEVITTOWN
Practice Address - Street 2:CALLE LIZZIE GRAHAM
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-404-6196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6016231OtherDRIVERS LICENSE