Provider Demographics
NPI:1861714008
Name:CANUELAS, YEYCA (PSYD)
Entity type:Individual
Prefix:DR
First Name:YEYCA
Middle Name:
Last Name:CANUELAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CALLE GUAMANI
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8701
Mailing Address - Country:US
Mailing Address - Phone:787-737-7636
Mailing Address - Fax:
Practice Address - Street 1:CALLE SANTIAGO NORTE #53
Practice Address - Street 2:NORTE
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-1348
Practice Address - Country:US
Practice Address - Phone:787-737-7636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3508103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical