Healthcare Provider Details

I. General information

NPI: 1053239822
Provider Name (Legal Business Name): CHEYENNE RODRIGUEZ-HECTOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 CENTRAL AVE
NEEDHAM MA
02492-1410
US

IV. Provider business mailing address

43 GALLIVAN BLVD
BOSTON MA
02124-4516
US

V. Phone/Fax

Practice location:
  • Phone: 781-292-2196
  • Fax:
Mailing address:
  • Phone: 617-606-1259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: