Provider Demographics
NPI:1528839909
Name:ENRIQUEZ RODRIGUEZ, ROCIO III
Entity type:Individual
Prefix:MISS
First Name:ROCIO
Middle Name:
Last Name:ENRIQUEZ RODRIGUEZ
Suffix:III
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 1:4346 BRENTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-4815
Mailing Address - Country:US
Mailing Address - Phone:561-574-8784
Mailing Address - Fax:
Practice Address - Street 1:4346 BRENTWOOD CT
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-4815
Practice Address - Country:US
Practice Address - Phone:561-574-8784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-24-320168106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician