Provider Demographics
NPI:1447716998
Name:RONDON AYALA, YARISBEL MARIE (PSYD)
Entity type:Individual
Prefix:
First Name:YARISBEL
Middle Name:MARIE
Last Name:RONDON AYALA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#200 CALLE MARKINA
Mailing Address - Street 2:URB. EL PEDREGAL
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-538-5863
Mailing Address - Fax:
Practice Address - Street 1:#200 CALLE MARKINA
Practice Address - Street 2:URB. EL PEDREGAL
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-538-5863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6288103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical