Individual
MISS JESSICA ALICIA RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178018894
IL
103TC0700X
Clinical Psychologist
103TC0700X
IL
Other
Enumeration date
01/28/2022
Last updated
04/20/2023
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