| NPI | 1265176523 |
|---|---|
| Former Name | JACQUELYN PAOLA RODRIGUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C11220) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2026-02-06 |