Provider Demographics
NPI:1851664957
Name:RODRIGUEZ, JOELLE (MED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JOELLE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 LUNALILO ST APT 1205
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-3974
Mailing Address - Country:US
Mailing Address - Phone:808-779-3566
Mailing Address - Fax:
Practice Address - Street 1:1050 LUNALILO ST APT 1205
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-3974
Practice Address - Country:US
Practice Address - Phone:808-779-3566
Practice Address - Fax:877-522-8210
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBA-3103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst