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Individual

MICHAEL A. RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
31-36 88TH STREET, JACKSON DEVELOPMENTAL CENTER, JACKSON HEIGHTS, NY 11369
(718) 205-1919
(718) 205-0178
Mailing address
89-23 210TH ST., QUEENS VILLAGE, NY 11427-2226
(917) 687-5623

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
651391122
NY

Other

Enumeration date
08/28/2012
Last updated
08/28/2012
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