Provider Demographics
NPI:1023526605
Name:PEREZ RIOS, YEIRALIS (MSW)
Entity type:Individual
Prefix:
First Name:YEIRALIS
Middle Name:
Last Name:PEREZ RIOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 92580
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9552
Mailing Address - Country:US
Mailing Address - Phone:787-566-2428
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 660
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-0660
Practice Address - Country:US
Practice Address - Phone:787-898-2660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR139071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty