Provider Demographics
NPI:1154989804
Name:MONTERO, YARELIS (MASTER DEGREE)
Entity type:Individual
Prefix:MRS
First Name:YARELIS
Middle Name:
Last Name:MONTERO
Suffix:
Gender:F
Credentials:MASTER DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E9 CALLE PALOMA
Mailing Address - Street 2:URB LAS GAVIOTAS
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-648-4736
Mailing Address - Fax:
Practice Address - Street 1:E9 CALLE PALOMA
Practice Address - Street 2:URB LAS GAVIOTAS
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-648-4736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5834103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling