Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor |
NPI | 1124223656 |
---|---|
Provider Name | Dr. Alicia Rodriguez Marroquin |
First Address | North Bend, OR 97459-3643 |
Second Address | North Bend, OR 97459-3643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 07/01/2014 |