Provider Demographics
NPI:1114272127
Name:METOYER-RODRIGUEZ, MARGARITA (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MARGARITA
Middle Name:
Last Name:METOYER-RODRIGUEZ
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9327 LAVERGNE AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1315
Mailing Address - Country:US
Mailing Address - Phone:773-706-4575
Mailing Address - Fax:
Practice Address - Street 1:9327 LAVERGNE AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1315
Practice Address - Country:US
Practice Address - Phone:773-706-4575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-12-1005103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst