Provider Demographics
NPI:1235969197
Name:MARTINEZ CHIANG, YENLI
Entity type:Individual
Prefix:
First Name:YENLI
Middle Name:
Last Name:MARTINEZ CHIANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15730 SW 147TH AVE FL 33187
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-5512
Mailing Address - Country:US
Mailing Address - Phone:786-453-1527
Mailing Address - Fax:
Practice Address - Street 1:15730 SW 147TH AVE FL 33187
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-5512
Practice Address - Country:US
Practice Address - Phone:786-453-1527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician