Provider Demographics
NPI:1336951300
Name:BETANCOURT, YANET
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:BETANCOURT
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 1:1311 NE 125TH ST APT 208
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5984
Mailing Address - Country:US
Mailing Address - Phone:786-590-8024
Mailing Address - Fax:
Practice Address - Street 1:1311 NE 125TH ST APT 208
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5984
Practice Address - Country:US
Practice Address - Phone:786-590-8024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician