Provider Demographics
NPI:1720526577
Name:RODRIGUEZ, RACHEL (CDA, MPA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CDA, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14573 GRASSY COVE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-6336
Mailing Address - Country:US
Mailing Address - Phone:407-895-0801
Mailing Address - Fax:407-895-0803
Practice Address - Street 1:8617 E COLONIAL DR
Practice Address - Street 2:STE #1100
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-3938
Practice Address - Country:US
Practice Address - Phone:407-895-0801
Practice Address - Fax:407-895-0803
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician