Healthcare Provider Details

I. General information

NPI: 1477713014
Provider Name (Legal Business Name): KIMBERLY ZLOMKE RODRIGUEZ PH.D., BCBA-D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 DOWNTOWNER BLVD
MOBILE AL
36609-5406
US

IV. Provider business mailing address

254 E MOUNT ISLAND DR
MOBILE AL
36606-1843
US

V. Phone/Fax

Practice location:
  • Phone: 251-480-0070
  • Fax:
Mailing address:
  • Phone: 251-460-6569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number8621
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1634
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-05-2487-2005
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: