Provider Demographics
NPI:1609692425
Name:MOLINA YAMBO, DELMARIS
Entity type:Individual
Prefix:
First Name:DELMARIS
Middle Name:
Last Name:MOLINA YAMBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DELMARIS
Other - Middle Name:
Other - Last Name:MOLINA YAMBO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DELMARIS YAMBO
Mailing Address - Street 1:PRADERA DEL RIO 3235 CALLE RIO TALLABOA
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:605 AVE CONDADO STE 416
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-3814
Practice Address - Country:US
Practice Address - Phone:787-452-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling