Individual
MS. LISA MARIE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ED
Contact information
Practice address
2169 81ST ST, BROOKLYN, NY 11214-2593
(917) 318-1689
Mailing address
2169 81ST ST, BROOKLYN, NY 11214-2593
(917) 318-1689
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
002193
NY
174400000X
Specialist
522068111
NY
Other
Enumeration date
06/09/2012
Last updated
08/09/2022
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