Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PR | |
N | 103T00000X | Psychologist | PR | |
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 359 | PR |
N | 103TH0100X | Health Service | PR |
NPI | 1396055364 |
---|---|
Provider Name | Dr. Ariadne Rodriguez I |
First Address | Ponce, PR 00728-2654 |
Second Address | Ponce, PR 00728-2654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2010 |
Last Update Date | 08/10/2010 |