Provider Demographics
NPI:1386480747
Name:RODRIGUEZ, JOSEPHINE MICHAELA
Entity type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:MICHAELA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JOSEPHINE
Other - Middle Name:MICHAELA
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6060 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1907
Mailing Address - Country:US
Mailing Address - Phone:317-815-5501
Mailing Address - Fax:
Practice Address - Street 1:40 CHRISTOPHER WAY STE 103
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3346
Practice Address - Country:US
Practice Address - Phone:732-867-0234
Practice Address - Fax:800-931-8113
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-23-64573103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst