Provider Demographics
NPI:1285172569
Name:DE LA TEJERA, YANET
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:DE LA TEJERA
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 1:21400 SW 87TH PL
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-7336
Mailing Address - Country:US
Mailing Address - Phone:786-554-1595
Mailing Address - Fax:
Practice Address - Street 1:21400 SW 87TH PL
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-7336
Practice Address - Country:US
Practice Address - Phone:786-554-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health