Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 6129 | PR |
Y | 103G00000X | Clinical Psychologist | 6129 | PR |
Y | 103TC0700X | Clinical Psychologist | 6129 | PR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 6129 | PR |
NPI | 1205322237 |
---|---|
Provider Name | Dr. Laura B Rodriguez |
First Address | Toa Baja, PR 00950-0951 |
Second Address | Toa Baja, PR 00950 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2018 |
Last Update Date | 02/07/2018 |