Provider Demographics
NPI:1720706807
Name:RODRIGUEZ, MARITZA PAULETTE
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:PAULETTE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-3584
Mailing Address - Country:US
Mailing Address - Phone:785-416-0071
Mailing Address - Fax:
Practice Address - Street 1:200 MAINE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1368
Practice Address - Country:US
Practice Address - Phone:785-843-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker