Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 67990 | TX |
NPI | 1003449109 |
---|---|
Provider Name | Raquel R Rodriguez |
First Address | Donna, TX 78537-5479 |
Second Address | Donna, TX 78537-5479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2020 |
Last Update Date | 17/02/2020 |