Provider Demographics
NPI:1194351387
Name:RODRIGUEZ, NEMESIS YOLIAN (CLINIC SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:NEMESIS
Middle Name:YOLIAN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CLINIC SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CALLE WILSON TORRES
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-3211
Mailing Address - Country:US
Mailing Address - Phone:787-470-6812
Mailing Address - Fax:
Practice Address - Street 1:AVE RAFAEL CORDERO ESQ TROCHE
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-745-0340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR234371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical