Healthcare Provider Details
I. General information
NPI: 1114646148
Provider Name (Legal Business Name): ASHLEY REIS RODRIGUES H.I.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/23/2022
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
49 STATE RD STE 201
DARTMOUTH MA
02747-3322
US
IV. Provider business mailing address
1822 N MAIN ST STE 201
FALL RIVER MA
02720-1350
US
V. Phone/Fax
- Phone: 508-910-2221
- Fax: 508-910-2214
- Phone: 508-674-3334
- Fax: 508-674-5855
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | HES516 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: