Individual
CARISSA RAE RODDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCC
Contact information
Practice address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
Mailing address
609 WINDBROOK DR, ELIZABETHTOWN, KY 42701-6827
(816) 646-9897
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
282370
KY
Other
Enumeration date
10/19/2020
Last updated
12/26/2022
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