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General NPI Number Information
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NPI Number | 1790683225
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Entity Type | Individual
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Provider Name | TYANNA JULINHA FERNANDES RBT
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Gender | Female
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Dates
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Enumeration Date | 10/26/2026
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Last Update Date | 10/26/2026
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Provider Practice Location Address
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Address Line | 170 PLEASANT ST STE 100
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City | FALL RIVER
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State | MA
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Zip | 02721-3015
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Country | US
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Telephone | 774-294-5722
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 N MAIN ST APT 1B
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City | FALL RIVER
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State | MA
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Zip | 02720-2016
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Country | US
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Telephone | 774-627-0711
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-26-541195
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License Number State | MA
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