Provider Demographics
NPI:1932970654
Name:GERENA, YADILKA MARIE
Entity Type:Individual
Prefix:
First Name:YADILKA
Middle Name:MARIE
Last Name:GERENA
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 81
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-0081
Mailing Address - Country:US
Mailing Address - Phone:787-930-9135
Mailing Address - Fax:
Practice Address - Street 1:COLLORES 926
Practice Address - Street 2:KM 2.0 KM 0.2
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-0081
Practice Address - Country:US
Practice Address - Phone:787-930-9135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR254971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical