Provider Demographics
NPI:1841822871
Name:RODRIGUEZ, DANIELLE (MA, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 SAMS ROAD
Mailing Address - Street 2:UNIT C
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-7520
Mailing Address - Country:US
Mailing Address - Phone:203-832-4389
Mailing Address - Fax:
Practice Address - Street 1:10 PROGRESS DR
Practice Address - Street 2:UNIT 2B
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484
Practice Address - Country:US
Practice Address - Phone:475-239-5512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-19-37044103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst