Individual
MRS. JUANITA MARIE RODRIGUEZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LADC,NCAC I,Q-SAP,
Contact information
Practice address
1321 BROADWAY, SCOTTSBLUFF, NE 69361-3579
(308) 632-7411
(308) 632-7423
Mailing address
2201 KINGSGATE RD, SCOTTSBLUFF, NE 69361-4824
(308) 635-7707
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20
NE
Other
Enumeration date
06/16/2006
Last updated
07/08/2007
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