Individual
SHADE CHANTEL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
5542 WHITES FERRY RD LOT 4, WEST MONROE, LA 71291-8839
(318) 614-7826
Mailing address
2321 US-80, MONROE, LA 71203
(318) 600-3333
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5718
LA
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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