Individual
KIEFER MARLON RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
446A BLAKE ST, NEW HAVEN, CT 06515-4437
(203) 387-9400
Mailing address
26 LANDIN ST FL 1, WOODBRIDGE, CT 06525-2224
(203) 999-4460
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
9902
CT
101YA0400X
Addiction (Substance Use Disorder) Counselor
9902
CT
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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