Provider Demographics
NPI:1639960842
Name:DE LA PAZ RODRIGUEZ, YODELYS
Entity type:Individual
Prefix:MRS
First Name:YODELYS
Middle Name:
Last Name:DE LA PAZ RODRIGUEZ
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 1:5060 W HACIENDA AVE APT 2005
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-0340
Mailing Address - Country:US
Mailing Address - Phone:239-357-9131
Mailing Address - Fax:
Practice Address - Street 1:2920 S RAINBOW BLVD STE 180
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6227
Practice Address - Country:US
Practice Address - Phone:702-600-0099
Practice Address - Fax:702-602-9393
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-25-424401106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician