Individual
MRS. SHELLY HOULE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC, LADC
Contact information
Practice address
1205 UPPER PLEASANT VALLEY RD, JEFFERSONVILLE, VT 05444
(802) 324-4803
Mailing address
272 NORTH MAINE STREET, ROOM # 223, CAMBRIDGE, VT 05444
(802) 644-1460
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000482
VT
101YM0800X
Mental Health Counselor
Primary
0680057754
VT
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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