| NPI | 1215587308 |
|---|---|
| Former Name | JACQUELINE NICOLE RODEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP142634) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2021-10-14 |