Provider Demographics
NPI:1942588470
Name:RODRIQUEZ, ALFREDA MARIA (COTA/L)
Entity Type:Individual
Prefix:
First Name:ALFREDA
Middle Name:MARIA
Last Name:RODRIQUEZ
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6192 WHITE DEER RD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:DE
Mailing Address - Zip Code:19940-3142
Mailing Address - Country:US
Mailing Address - Phone:302-846-3324
Mailing Address - Fax:
Practice Address - Street 1:6192 WHITE DEER RD
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:DE
Practice Address - Zip Code:19940-3142
Practice Address - Country:US
Practice Address - Phone:302-846-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA01859224Z00000X
DEU2001243224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant