Individual
MS. AUTUMN LEA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 221-1996
Mailing address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106095
TX
Other
Enumeration date
11/06/2023
Last updated
12/11/2023
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