Individual
MS. JESSICA RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5472 W LOOP 1604 N, SUITE 45, SAN ANTONIO, TX 78251
(860) 617-2012
Mailing address
5472 W LOOP 1604 N, SUITE 45 VISTA SALON, SAN ANTONIO TEXAS, TX 78251
(860) 617-2012
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
TX
222Q00000X
Developmental Therapist
—
—
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/14/2019
Last updated
03/12/2024
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