Provider Demographics
NPI:1386829158
Name:RODRIGUEZ, ANGELINA HENRIETTA (LPC ATR BC)
Entity Type:Individual
Prefix:MS
First Name:ANGELINA
Middle Name:HENRIETTA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LPC ATR BC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:HENRIETTA
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC ATR BC
Mailing Address - Street 1:6750 W LOOP SOUTH
Mailing Address - Street 2:STE 225
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401
Mailing Address - Country:US
Mailing Address - Phone:713-206-8429
Mailing Address - Fax:
Practice Address - Street 1:6750 W LOOP SOUTH
Practice Address - Street 2:STE 225
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-206-8429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-29
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19450101YP2500X
TX00027221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist