Provider Demographics
NPI:1003415852
Name:RODRIGUEZ, BETSY ROSE (LMHC)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:ROSE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 E CUMBERLAND AVE # 201H-132
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4231
Mailing Address - Country:US
Mailing Address - Phone:754-300-8107
Mailing Address - Fax:
Practice Address - Street 1:1101 E CUMBERLAND AVE # 201H-132
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4231
Practice Address - Country:US
Practice Address - Phone:754-300-8107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health