Individual
MICHELLE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBHCM-S. 100674
Contact information
Practice address
2219 MALLORY CIR, HAINES CITY, FL 33844-2412
(863) 207-2289
Mailing address
2219 MALLORY CIR, HAINES CITY, FL 33844-2412
(863) 207-2289
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CBHCMS100674
FL
104100000X
Social Worker
—
FL
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
L170000252495
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016395300
—
FL
Enumeration date
07/16/2015
Last updated
04/24/2020
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