Individual
MARIA LUIZA RODRIGUEZ VIDALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1345 COMPANION CT, SUMTER, SC 29150-1749
(803) 529-1366
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-509280
—
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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