Individual
KANISHA MARIE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
3020 WOODCREEK DR STE A2, DOWNERS GROVE, IL 60515-5416
(630) 797-9807
Mailing address
2017 WALNUT ST, BLUE ISLAND, IL 60406-2226
(708) 752-2524
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.111678
IL
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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