Provider Demographics
NPI:1073059440
Name:RODRIGUEZ, BRANDI (MS, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3049 AIRHAVEN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-2450
Mailing Address - Country:US
Mailing Address - Phone:903-720-0531
Mailing Address - Fax:
Practice Address - Street 1:3049 AIRHAVEN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-2450
Practice Address - Country:US
Practice Address - Phone:903-720-0531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76940101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional