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General NPI Number Information
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NPI Number | 1851208722
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Entity Type | Individual
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Provider Name | MARIAH MIA RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 3351 HOBSON RD STE B
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City | WOODRIDGE
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State | IL
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Zip | 60517-1689
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Country | US
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Telephone | 630-381-7755
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Fax | 630-381-7755
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Provider Business Mailing Address
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Address Line | 100 RENAISSANCE BLVD
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-4806
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | IL
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