Basic Information
| Provider Information | |||||||||
| NPI: | 1356503130 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUIZ-TORRES | ||||||||
| FirstName: | YAMILETTE | ||||||||
| MiddleName: | |||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9809 | ||||||||
| Address2: | |||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007269809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877094130 | ||||||||
| FaxNumber: | 7877094134 | ||||||||
| Practice Location | |||||||||
| Address1: | 184 CALLE GUADALUPE FINAL | ||||||||
| Address2: | ANTIGUO HOSPITAL SAN LUCAS | ||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877094130 | ||||||||
| FaxNumber: | 7877094134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2008 | ||||||||
| LastUpdateDate: | 03/12/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 3045 | PR | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.