Provider Demographics
NPI:1801308820
Name:DOMINGUEZ OLIVIERI, YAMILETTE (THL)
Entity type:Individual
Prefix:MRS
First Name:YAMILETTE
Middle Name:
Last Name:DOMINGUEZ OLIVIERI
Suffix:
Gender:F
Credentials:THL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 5760
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-9837
Mailing Address - Country:US
Mailing Address - Phone:939-403-7713
Mailing Address - Fax:
Practice Address - Street 1:CARR 123 KM 10.1
Practice Address - Street 2:BO MAGUEYES
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730
Practice Address - Country:US
Practice Address - Phone:787-651-7691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0070802355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant