| NPI | 1780928424 |
|---|---|
| Former Name | JESSICA NICOLE RODRIGUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCSW114622) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA ASW76862) |
| 101YM0800X Counselor Mental Health (Licence: CA LCSW114622) | |
| 1041S0200X Social Worker School | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2024-10-07 |