Provider Demographics
NPI:1265224851
Name:HARRIS, YVONNE RODRIGUEZ
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:RODRIGUEZ
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5719
Mailing Address - Country:US
Mailing Address - Phone:225-346-4040
Mailing Address - Fax:225-381-8094
Practice Address - Street 1:3535 GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-5719
Practice Address - Country:US
Practice Address - Phone:225-346-4040
Practice Address - Fax:225-381-8094
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1396904272Medicaid
LA1750417416Medicaid
LA1992964498Medicaid
LA1952560450Medicaid