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Individual

MARTIN RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCADC

Contact information

Practice address
110 MARTIN LUTHER DRIVE, JERSEY CITY, NJ 07305
(201) 200-1965
Mailing address
PO BOX 15802, JERSEY CITY, NJ 07305-0802
(201) 200-1965

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00199700
NJ

Other

Enumeration date
12/19/2014
Last updated
12/19/2014
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