Provider Demographics
NPI:1811026644
Name:RODRIGUEZ, CLAUDIA LETICIA (MA)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:LETICIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2489 LANCASTER DR NE BLDG D
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1219
Mailing Address - Country:US
Mailing Address - Phone:503-487-7738
Mailing Address - Fax:503-967-6910
Practice Address - Street 1:2489 LANCASTER DR NE BLDG D
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1219
Practice Address - Country:US
Practice Address - Phone:503-487-7738
Practice Address - Fax:503-967-6910
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0824101YM0800X, 106H00000X
ORC3112101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional