Individual
JILL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
347 HOOVER BLVD, SUITE A, HOLLAND, MI 49423-5802
(616) 392-7695
(616) 392-6955
Mailing address
217 SUNRISE DR, HOLLAND, MI 49423
(616) 392-7695
(616) 392-6955
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401005181
MI
103TC0700X
Clinical Psychologist
Primary
6301009748
MI
103TS0200X
School Psychologist
—
MI
Other
Enumeration date
10/04/2006
Last updated
11/11/2016
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