Provider Demographics
NPI:1124806419
Name:AFANADOR GONZALEZ, YELIANNE MARI (MS)
Entity type:Individual
Prefix:MRS
First Name:YELIANNE
Middle Name:MARI
Last Name:AFANADOR GONZALEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PARC. LOMAS VERDES CALLE OPALO
Mailing Address - Street 2:227
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676
Mailing Address - Country:US
Mailing Address - Phone:939-418-3364
Mailing Address - Fax:
Practice Address - Street 1:CARR. 129 KM 1.0 AVENIDA SAN LUIS
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-877-4743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7110103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist