Individual
LUIS ERNESTO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
302 EUSTIS ST, ROXBURY, MA 02119-3800
(617) 445-1123
(857) 547-1186
Mailing address
302 EUSTIS ST, ROXBURY, MA 02119-3800
(617) 445-1123
(857) 547-1186
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
41491644
TX
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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