Provider Demographics
NPI:1851003149
Name:RODRIGUEZ, TERESA LEE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:LEE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14742 FALL CREEK PRESERVE DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4562
Mailing Address - Country:US
Mailing Address - Phone:832-661-5565
Mailing Address - Fax:
Practice Address - Street 1:14742 FALL CREEK PRESERVE DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4562
Practice Address - Country:US
Practice Address - Phone:832-661-5565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional