Provider Demographics
NPI:1134613557
Name:RODRIGUEZ, TORRI KAITLIN (BA, RBT)
Entity type:Individual
Prefix:
First Name:TORRI
Middle Name:KAITLIN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BA, RBT
Other - Prefix:
Other - First Name:TORRI
Other - Middle Name:KAITLIN
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:9302 E 22ND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-7342
Practice Address - Country:US
Practice Address - Phone:520-278-5758
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-18-63940106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician