Provider Demographics
NPI:1841791068
Name:RODRIGUEZ, CRISTINA PAULINE (BCBA)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:PAULINE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:PAULINE
Other - Last Name:SPAGNOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT, BCBA
Mailing Address - Street 1:11914 S ROUTE 59 UNIT 134
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-5110
Mailing Address - Country:US
Mailing Address - Phone:815-469-1500
Mailing Address - Fax:
Practice Address - Street 1:11914 S ROUTE 59 UNIT 134
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-5110
Practice Address - Country:US
Practice Address - Phone:815-469-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-22-61442103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst