Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1134585805 |
---|---|
Provider Name | Sofia Rodriguez |
First Address | Palm Springs, CA 92262-7905 |
Second Address | Palm Springs, CA 92262-7905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2016 |
Last Update Date | 11/01/2016 |