Provider Demographics
NPI:1770778615
Name:ISLAS, YANIRA MICHELLE (OTR)
Entity type:Individual
Prefix:MRS
First Name:YANIRA
Middle Name:MICHELLE
Last Name:ISLAS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:YANIRA
Other - Middle Name:MICHELLE
Other - Last Name:LEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2123 DEBBIE DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-5121
Mailing Address - Country:US
Mailing Address - Phone:956-381-5788
Mailing Address - Fax:956-688-6114
Practice Address - Street 1:3141 CENTER POINT DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8433
Practice Address - Country:US
Practice Address - Phone:956-688-5781
Practice Address - Fax:956-688-6114
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111883225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist