Individual
MONICA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, MAC, MA
Contact information
Practice address
405 EAST FOREST STREET, SUITE 119, OCONOMOWOC, WI 53066
(262) 490-3894
Mailing address
405 E. FOREST STREET, SUITE 119, OCONOMOWOC, WI 53066
(262) 490-3894
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5807-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100048954
—
WI
Enumeration date
01/06/2015
Last updated
02/20/2017
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