Provider Demographics
NPI:1487948287
Name:MERCER, YVONNE I (MA)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:I
Last Name:MERCER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0507
Mailing Address - Country:US
Mailing Address - Phone:787-967-8515
Mailing Address - Fax:
Practice Address - Street 1:CARR. 4403 KM. 2.1 INT.
Practice Address - Street 2:BO. AJIES
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-0507
Practice Address - Country:US
Practice Address - Phone:787-967-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3128103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool