Individual
MICHELLE EVETTE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1504 LEANDER RD, GEORGETOWN, TX 78628-8801
(512) 337-9399
Mailing address
PO BOX 1453, BASTROP, TX 78602-1453
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
203675
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203675
TEXAS STATE BOARD OF MARRIAGE AND FAMILY THERAPISTS
TX
Enumeration date
01/17/2019
Last updated
02/04/2022
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