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Individual

MRS. SAN JUANA SAN RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1824 FLINT DRIVE, SUITE 104, STORM LAKE, IA 50558
(712) 262-2922
(712) 262-3826
Mailing address
PO BOX 177, AURELIA, IA 51005-0177
(712) 299-2182

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24011
IA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T24011
IA
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
03/12/2007
Last updated
02/25/2026
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