Provider Demographics
NPI:1346922515
Name:SALAS DEVILLE, YELINA
Entity type:Individual
Prefix:
First Name:YELINA
Middle Name:
Last Name:SALAS DEVILLE
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 1:40 W 4TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4752
Mailing Address - Country:US
Mailing Address - Phone:786-714-6879
Mailing Address - Fax:
Practice Address - Street 1:40 W 4TH ST APT 1
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4752
Practice Address - Country:US
Practice Address - Phone:786-714-6879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-278700106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician