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General NPI Number Information
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NPI Number | 1457026155
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Entity Type | Individual
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Provider Name | EMILY VICTORIA RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 1081 OAK ST STE 3
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City | PITTSTON
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State | PA
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Zip | 18640-3716
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Country | US
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Telephone | 570-302-3098
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Fax |
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Provider Business Mailing Address
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Address Line | 324 DOLPH ST
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City | JESSUP
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State | PA
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Zip | 18434-1008
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Country | US
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Telephone | 845-800-5236
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-80157
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License Number State | PA
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