Provider Demographics
NPI:1336457043
Name:RODRIGUEZ, LIAYNE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:LIAYNE
Middle Name:
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:PO BOX 900685
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33090-0685
Mailing Address - Country:US
Mailing Address - Phone:305-247-1388
Mailing Address - Fax:305-247-1362
Practice Address - Street 1:28905 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-2481
Practice Address - Country:US
Practice Address - Phone:305-247-1388
Practice Address - Fax:305-247-1362
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9702101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health