Provider Demographics
NPI:1194043224
Name:RODRIGUES, CANDIDO B (SOCIAL WORKER)
Entity Type:Individual
Prefix:MR
First Name:CANDIDO
Middle Name:B
Last Name:RODRIGUES
Suffix:
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2724
Mailing Address - Country:US
Mailing Address - Phone:508-941-0005
Mailing Address - Fax:508-997-1921
Practice Address - Street 1:157 CENTRE ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2724
Practice Address - Country:US
Practice Address - Phone:508-941-0005
Practice Address - Fax:508-997-1921
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker