Individual
JIMMY RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3584 JEROME AVE, BRONX, NY 10467-1006
(718) 653-1537
Mailing address
754 BRADY AVE APT 503, BRONX, NY 10462-2779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
31241
NY
Other
Enumeration date
03/20/2020
Last updated
10/25/2021
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