Individual
MARJORIE DIAZ RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, BCBA
Contact information
Practice address
3417 N KENNICOTT AVE STE A, ARLINGTON HEIGHTS, IL 60004-7824
(224) 210-6694
(224) 836-5174
Mailing address
1261 E PALATINE RD, PALATINE, IL 60074-5777
(847) 772-2029
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-37412
IL
1041C0700X
Clinical Social Worker
149.011093
IL
Other
Enumeration date
08/28/2010
Last updated
09/23/2019
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