MEDICARE: MRS. YEHSICA RASHENI FOLKERDS RBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1053882456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YEHSICA RASHENI FOLKERDS RBT

Provider Business Mailing Address
First Line	:	555 31ST AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-2090
Country	:	US
Telephone Number	:	772-224-0741
Fax Number	:

Provider Business Practice Location Address
First Line	:	5080 TOPAZ LN SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-5863
Country	:	US
Telephone Number	:	305-393-0179
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2018
Last Update Date	:	12/10/2018

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