Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 60256647 | WA |
N | 101YM0800X | Mental Health Counselor | 60296838 | WA |
Y | 101YP2500X | Professional Counselor | 80992 | TX |
N | 101YS0200X | School Counselor | 343354 | NM |
N | 101YS0200X | School Counselor | 485664G | WA |
N | 101YS0200X | School Counselor | 86119 | MT |
NPI | 1255778999 |
---|---|
Provider Name | Mrs. Jenny Jesus Rodriguez |
First Address | San Antonio, TX 78213-4293 |
Second Address | San Antonio, TX 78207-4444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2013 |
Last Update Date | 11/04/2019 |