Provider Demographics
NPI:1891931994
Name:ACACIO-RODRIGUERA, LORIE ANNE AGBAYANI
Entity type:Individual
Prefix:
First Name:LORIE ANNE
Middle Name:AGBAYANI
Last Name:ACACIO-RODRIGUERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORIE ANNE
Other - Middle Name:AGBAYANI
Other - Last Name:ACACIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:907 N DUPONT BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1060
Mailing Address - Country:US
Mailing Address - Phone:302-444-8318
Mailing Address - Fax:302-422-2768
Practice Address - Street 1:907 N DUPONT BLVD STE 104
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1060
Practice Address - Country:US
Practice Address - Phone:302-444-8318
Practice Address - Fax:302-422-2768
Is Sole Proprietor?:No
Enumeration Date:2008-12-20
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist