Basic Information
| Provider Information | |||||||||
| NPI: | 1386309359 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MERCED | ||||||||
| FirstName: | YARIMAR | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9809 | ||||||||
| Address2: | |||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007269809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877070705 | ||||||||
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| Practice Location | |||||||||
| Address1: | 431 AVE HOSTOS | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009183014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877040705 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2021 | ||||||||
| LastUpdateDate: | 01/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 5951 | PR | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.