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MS. PAULINE EVA RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSVE

Contact information

Practice address
122 1ST AVE, SUITE 201, FAIRBANKS, AK 99701-4803
(907) 452-6434
(907) 451-6598
Mailing address
122 1ST AVE, SUITE 201, FAIRBANKS, AK 99701-4803
(907) 452-6434
(907) 451-6598

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251C00000X
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
251C00000X
AK
Enumeration date
07/20/2010
Last updated
07/20/2010
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