Provider Demographics
NPI:1972718302
Name:PEREZ, YOLANDA HERNANDEZ
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:HERNANDEZ
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
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 607
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-0607
Mailing Address - Country:US
Mailing Address - Phone:787-717-8068
Mailing Address - Fax:787-877-6976
Practice Address - Street 1:CARRETERA 111 KM. 0.6
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-717-8068
Practice Address - Fax:787-877-6976
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2404103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling