Provider Demographics
NPI:1861723876
Name:RODRIGUEZ, ROSE ELIZABETH (MS COUNSELING)
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:ELIZABETH
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6413 EHLER COURT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409
Mailing Address - Country:US
Mailing Address - Phone:910-397-7634
Mailing Address - Fax:
Practice Address - Street 1:6413 EHLER CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-4553
Practice Address - Country:US
Practice Address - Phone:910-397-7634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health