Healthcare Provider Details
I. General information
NPI: 1447405857
Provider Name (Legal Business Name): YAMIL SARABIA LP-MHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/26/2008
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1990 LEXINGTON AVE APT 26E
NEW YORK NY
10035-2918
US
IV. Provider business mailing address
2041 HOBART AVE
BRONX NY
10461-3976
US
V. Phone/Fax
- Phone: 646-991-0661
- Fax:
- Phone: 212-239-2252
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 015120 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 18-P121309-01 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: