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NPI Code Detail

MEDICARE: DIANT'HA YANICE RODRIGUEZ

MEDICARE:   DIANT'HA YANICE RODRIGUEZ
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1508579731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANT'HA YANICE RODRIGUEZ
Provider Business Mailing Address
First Line : 32 LANSDOWNE ST APT 3
Second Line :
City : BROCKTON
State : MA
Zip : 02301-2347
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 234 COPELAND ST FL 4
Second Line :
City : QUINCY
State : MA
Zip : 02169-4082
Country : US
Telephone Number : 617-658-5610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2023
Last Update Date : 01/03/2023

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Directions to “ DIANT'HA YANICE RODRIGUEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.