Provider Demographics
NPI:1023595311
Name:RODRIGUEZ RIVERO, YANAY (BCBA)
Entity type:Individual
Prefix:
First Name:YANAY
Middle Name:
Last Name:RODRIGUEZ RIVERO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9857 COLONIAL WALK N
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-6307
Mailing Address - Country:US
Mailing Address - Phone:239-601-0709
Mailing Address - Fax:
Practice Address - Street 1:4522 EXECUTIVE DR STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-9014
Practice Address - Country:US
Practice Address - Phone:239-330-3502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106E00000X, 106S00000X
FL1-21-49727103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician