Provider Demographics
NPI:1144638099
Name:RODRIGUEZ, COURTNEY LEIGH (BCBA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LEIGH
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:LEIGH
Other - Last Name:DANNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2020 E HEBRON PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1609
Mailing Address - Country:US
Mailing Address - Phone:469-892-7500
Mailing Address - Fax:469-575-3002
Practice Address - Street 1:2020 E HEBRON PKWY STE 120
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007
Practice Address - Country:US
Practice Address - Phone:469-892-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-14-16548103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst