Provider Demographics
NPI:1275772287
Name:RODRIGUEZ, ROBYN LORI (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:LORI
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLYN
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-2430
Mailing Address - Country:US
Mailing Address - Phone:267-226-7438
Mailing Address - Fax:
Practice Address - Street 1:105 EVESBORO MEDFORD RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:609-353-5608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00526300101YP2500X
PAPC007487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional