Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 2967 | PR |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 2967 | PR |
Y | 103G00000X | Clinical Psychologist | 2967 | PR |
Y | 103TC0700X | Clinical Psychologist | 2967 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 2967 | PR |
N | 103TF0000X | Family Psychologist | 2967 | PR |
N | 103TF0200X | Forensic Psychologist | 2967 | PR |
N | 103TH0004X | Health Psychologist | 2967 | PR |
N | 103TH0100X | Health Service | 2967 | PR |
N | 103TM1800X | Intellectual & Developmental Disabilities | 2967 | PR |
N | 103TP2701X | Group Psychotherapist | 2967 | PR |
NPI | 1861667628 |
---|---|
Provider Name | Yazmin Deynes-Exclusa |
First Address | Humacao, PR 00791 |
Second Address | Humacao, PR 00791 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2008 |
Last Update Date | 28/05/2014 |