Provider Demographics
NPI:1982830089
Name:RODRIGUEZ, ESTHER (PHD)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1783 CARR 21
Mailing Address - Street 2:APT. 1703
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1783 CARR 21
Practice Address - Street 2:APT. 1703
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3319
Practice Address - Country:US
Practice Address - Phone:787-242-9850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR874103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical