Provider Demographics
NPI:1316476245
Name:ARTEAGA SIMON, YANELA ESTHER
Entity type:Individual
Prefix:
First Name:YANELA
Middle Name:ESTHER
Last Name:ARTEAGA SIMON
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 1:1740 SW 149TH PASS
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5783
Mailing Address - Country:US
Mailing Address - Phone:305-815-0931
Mailing Address - Fax:
Practice Address - Street 1:1740 SW 149TH PASS
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5783
Practice Address - Country:US
Practice Address - Phone:305-815-0931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-54060103K00000X, 103K00000X
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician