Individual
INGRID VANESSA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3347
(203) 503-3296
Mailing address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3347
(203) 503-3296
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
003115
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
11/06/2009
Last updated
07/13/2011
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