Provider Demographics
NPI:1982462800
Name:MENTOR, YANARAH
Entity type:Individual
Prefix:
First Name:YANARAH
Middle Name:
Last Name:MENTOR
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 1:840 GEORGE BUSH BLVD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5747
Mailing Address - Country:US
Mailing Address - Phone:561-268-3069
Mailing Address - Fax:
Practice Address - Street 1:1201 CARSON WAY APT 227
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-2244
Practice Address - Country:US
Practice Address - Phone:561-787-4004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion