Individual
EVELINA STARR RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2620 FORUM BLVD STE E, COLUMBIA, MO 65203-5454
(573) 514-8873
Mailing address
2620 FORUM BLVD STE E, COLUMBIA, MO 65203-5454
(573) 514-8873
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-320700
MO
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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