Individual
MRS. DIANA JANE RODERICK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1701 SOUTHWEST PKWY, SUITE 201, COLLEGE STATION, TX 77840-6911
(979) 764-8127
Mailing address
PO BOX 12019, COLLEGE STATION, TX 77842-2019
(979) 764-8127
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
16128
TX
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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