Provider Demographics
NPI:1194096297
Name:COLON-VALENTIN, YAMILIS (PSYD)
Entity type:Individual
Prefix:
First Name:YAMILIS
Middle Name:
Last Name:COLON-VALENTIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FARRAH LN APT 1523
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-6053
Mailing Address - Country:US
Mailing Address - Phone:939-940-2085
Mailing Address - Fax:
Practice Address - Street 1:4706 AIRPORT AVE
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5645
Practice Address - Country:US
Practice Address - Phone:281-239-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4091103TC0700X
TX38675103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical