Individual
MILDRED ILENE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
37 MAPLE ST, SUMMIT, NJ 07901-2529
(732) 674-9857
Mailing address
37 MAPLE ST, SUMMIT, NJ 07901-2529
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37AC00503700
NJ
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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