Individual
JUAN M RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1585 3RD ST, FORT JOHNSON, LA 71459-5102
(337) 531-3517
Mailing address
1585 3RD ST BLDG 285, FORT POLK, LA 71459-5102
(337) 531-2799
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
77726
TX
101YP2500X
Professional Counselor
Primary
8059
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3933079
—
TX
Enumeration date
02/12/2019
Last updated
07/17/2024
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