Basic Information
| Provider Information | |||||||||
| NPI: | 1760798417 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARRERO | ||||||||
| FirstName: | YARI | ||||||||
| MiddleName: | MARIEL | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MHS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 180 VALLE DE STA OLAYA | ||||||||
| Address2: | CALLE 5 I 180 | ||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009569467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877983001 | ||||||||
| FaxNumber: | 7872697550 | ||||||||
| Practice Location | |||||||||
| Address1: | HOSP. RAMON RUIZ ARNAU AVE. LAUREL | ||||||||
| Address2: | ESQUINA POWELL, SANTA JUANITA | ||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009606032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877983001 | ||||||||
| FaxNumber: | 7872697550 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2010 | ||||||||
| LastUpdateDate: | 08/19/2010 | ||||||||
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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 | 101YA0400X | 2261 | PR | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.