Provider Demographics
NPI:1730569518
Name:AVILA GUILLEN, YASMIN ESTHER (BACHELOR)
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:ESTHER
Last Name:AVILA GUILLEN
Suffix:
Gender:F
Credentials:BACHELOR
Other - Prefix:
Other - First Name:YASMIN
Other - Middle Name:ESTER
Other - Last Name:AVILA SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BACHELOR
Mailing Address - Street 1:10816 GREYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGE
Mailing Address - State:OK
Mailing Address - Zip Code:73120-3218
Mailing Address - Country:US
Mailing Address - Phone:405-637-6553
Mailing Address - Fax:
Practice Address - Street 1:10816 GREYSTONE AVE
Practice Address - Street 2:
Practice Address - City:THE VILLAGE
Practice Address - State:OK
Practice Address - Zip Code:73120-3218
Practice Address - Country:US
Practice Address - Phone:405-637-6553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator