Provider Demographics
NPI:1457564320
Name:OCASIO MARIN, YOLANDA (ADMINISTRATOR)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:OCASIO MARIN
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB.RAMIREZ #45 SAN JOSE ST.
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-851-0767
Mailing Address - Fax:787-851-0767
Practice Address - Street 1:WIPS THERAPEUTIC GROUP #70 RELAMPAGO ST.
Practice Address - Street 2:SUITE 101
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-833-2899
Practice Address - Fax:787-833-2899
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)