Individual
YALIANIS MENDIVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BEHAVIOR ASSISTANT
Contact information
Practice address
111 MOSBY DR, FOUNTAIN INN, SC 29644-6250
(848) 482-0485
Mailing address
111 MOSBY DR, FOUNTAIN INN, SC 29644-6250
(848) 482-0485
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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