Provider Demographics
NPI:1588346712
Name:ESCOBAR MARTIN, YARELY VALERIA
Entity type:Individual
Prefix:
First Name:YARELY
Middle Name:VALERIA
Last Name:ESCOBAR MARTIN
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 1:380 HARDING PL APT T1
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3933
Mailing Address - Country:US
Mailing Address - Phone:615-474-9074
Mailing Address - Fax:
Practice Address - Street 1:4701 TROUSDALE DR STE 114
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-1398
Practice Address - Country:US
Practice Address - Phone:615-447-8054
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 Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist