Provider Demographics
NPI:1093908402
Name:RODRIGUEZ, VALERIE DAWN (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:DAWN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W MECHANIC AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64050-1769
Mailing Address - Country:US
Mailing Address - Phone:913-676-7067
Mailing Address - Fax:816-521-2755
Practice Address - Street 1:600 W MECHANIC AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-1769
Practice Address - Country:US
Practice Address - Phone:913-676-7067
Practice Address - Fax:816-521-2755
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS37631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical