Healthcare Provider Details

I. General information

NPI: 1609692425
Provider Name (Legal Business Name): DELMARIS MOLINA YAMBO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DELMARIS MOLINA YAMBO DELMARIS YAMBO

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 11/26/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 AVE CONDADO STE 416
SAN JUAN PR
00907-3814
US

IV. Provider business mailing address

PRADERA DEL RIO 3235 CALLE RIO TALLABOA
TOA ALTA PR
00953
US

V. Phone/Fax

Practice location:
  • Phone: 787-452-4748
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: