Provider Demographics
NPI:1063224640
Name:CORREA, YUBY NORELEY
Entity type:Individual
Prefix:
First Name:YUBY
Middle Name:NORELEY
Last Name:CORREA
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 1:4155 WIMBLEDON DR # 125
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1136
Mailing Address - Country:US
Mailing Address - Phone:954-589-9615
Mailing Address - Fax:
Practice Address - Street 1:4155 WIMBLEDON DR # 125
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-1136
Practice Address - Country:US
Practice Address - Phone:954-589-9615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL393373106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician