Provider Demographics
NPI:1447898903
Name:ORTIZ-MERINO, ANA YARIS (MS)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:YARIS
Last Name:ORTIZ-MERINO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB VEREDAS
Mailing Address - Street 2:658 CALLE CAMINO DE LOS JAZMINES
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0000
Mailing Address - Country:US
Mailing Address - Phone:787-220-9396
Mailing Address - Fax:
Practice Address - Street 1:URB VEREDAS
Practice Address - Street 2:658 CALLE CAMINO DE LOS JAZMINES
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-0000
Practice Address - Country:US
Practice Address - Phone:787-220-9396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6532103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6532OtherMS LICENSE