Healthcare Provider Details

I. General information

NPI: 1538066337
Provider Name (Legal Business Name): YENESY RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2026
Last Update Date: 10/23/2026
Certification Date: 10/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 PLEASANT ST STE 100
FALL RIVER MA
02721-3015
US

IV. Provider business mailing address

804 PRESIDENT AVE # 1E
FALL RIVER MA
02720-5526
US

V. Phone/Fax

Practice location:
  • Phone: 774-294-5722
  • Fax:
Mailing address:
  • Phone: 508-974-2844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: