Individual
KELLY ANN RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-7555
(215) 590-7387
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-7555
(215) 590-7387
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
B1 0000998
DE
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS017685
PA
Other
Enumeration date
10/03/2014
Last updated
07/20/2016
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