Provider Demographics
NPI:1285920819
Name:VIRELLA, MONICA YARIT
Entity type:Individual
Prefix:MISS
First Name:MONICA
Middle Name:YARIT
Last Name:VIRELLA
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:BOULEVARD AVENUE 2ND. SECCION
Mailing Address - Street 2:2735
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-585-6046
Mailing Address - Fax:
Practice Address - Street 1:BOULEVARD AVENUE 2ND. SECCION
Practice Address - Street 2:# 2735
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-585-6046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1384235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist