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Individual

ROBERTO H RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CASAC-T

Contact information

Practice address
2976 NORTHERN BLVD FL 2, LONG ISLAND CITY, NY 11101-2829
(347) 510-3624
Mailing address
2976 NORTHERN BLVD FL 2, LONG ISLAND CITY, NY 11101-2829
(347) 510-3624

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30332
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02740141
NY
Enumeration date
07/22/2014
Last updated
07/22/2014
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