Provider Demographics
NPI:1396157707
Name:ALONSO, YANELLE
Entity type:Individual
Prefix:
First Name:YANELLE
Middle Name:
Last Name:ALONSO
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 1:955 SW 2ND AVE
Mailing Address - Street 2:APT 910
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3578
Mailing Address - Country:US
Mailing Address - Phone:786-499-2062
Mailing Address - Fax:
Practice Address - Street 1:955 SW 2ND AVE
Practice Address - Street 2:APT 910
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3578
Practice Address - Country:US
Practice Address - Phone:786-499-2062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist