Individual
MRS. TERA MARIE MAE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IPHM
Contact information
Practice address
620 12TH ST LOT 9C, KIEL, WI 53042-4830
(920) 571-7269
Mailing address
620 12TH ST LOT 9C, KIEL, WI 53042-4830
(920) 571-7269
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-24-377640
WI
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
WI
175T00000X
Peer Specialist
—
WI
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100413504
—
WI
Enumeration date
04/17/2026
Last updated
05/02/2026
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