Doctor Name: | MRS. YANET M PENA-TIRADO |
NPI Number: | 1861763971 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 414996101 |
Business Practice Address: | 12 Fillmore Dr Stony Point, NY - 109803705 |
Business Phone Number: | 8459474674 |
Business Fax Number: | |
Mailing Address: | 12 Fillmore Drive, STONY POINT |
State: | NY |
Postal Code: | 109803705 |
Phone Number: | 9176086033 |
Fax Number: | |
NPI Enumeration Date: | 01/20/2012 |
NPI Last Update Date: | 01/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 414996101 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |