Provider Demographics
NPI:1003040361
Name:RODRIGUEZ, ROSA JANET (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:JANET
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:V15 CALLE TUREY
Mailing Address - Street 2:EXTENSION CAGUAX
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3337
Mailing Address - Country:US
Mailing Address - Phone:787-903-9222
Mailing Address - Fax:787-773-8303
Practice Address - Street 1:1607 AVE PONCE DE LEON
Practice Address - Street 2:SUITE 109 COBIAN'S PLAZA
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909-1820
Practice Address - Country:US
Practice Address - Phone:787-903-9222
Practice Address - Fax:787-773-8303
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2896103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical