Individual
IVONNE M. RODRIGUEZ-SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
510 HIGHWAY 466 STE 203P, LADY LAKE, FL 32159-6341
(352) 614-0017
Mailing address
510 HIGHWAY 466 STE 203P, LADY LAKE, FL 32159-6341
(352) 614-0017
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10875
MA
103TC0700X
Clinical Psychologist
11123
MA
103TC0700X
Clinical Psychologist
Primary
PY10770
FL
Other
Enumeration date
04/07/2015
Last updated
04/27/2021
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