Doctor Name: | JONI ELIZABETH RODRIGUEZ |
NPI Number: | 1023482908 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, RESIDENT |
License Number: | |
Business Practice Address: | 102 Heritage Way Ne Ste 302 Leesburg, VA - 201764544 |
Business Phone Number: | 7037715100 |
Business Fax Number: | 7037770170 |
Mailing Address: | 102 Heritage Way Ne Ste 302, Po Box 7400 LEESBURG |
State: | VA |
Postal Code: | 201764544 |
Phone Number: | 7037715100 |
Fax Number: | 7037770170 |
NPI Enumeration Date: | 11/16/2015 |
NPI Last Update Date: | 11/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |