Provider Demographics
NPI:1871468777
Name:RHOADES, CODY (RBT)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:RHOADES
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2193 L G RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:FL
Mailing Address - Zip Code:32531-7477
Mailing Address - Country:US
Mailing Address - Phone:850-585-9189
Mailing Address - Fax:
Practice Address - Street 1:40 STATE HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPGS
Practice Address - State:FL
Practice Address - Zip Code:32433-7404
Practice Address - Country:US
Practice Address - Phone:850-585-9189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty