Provider Demographics
NPI:1205172343
Name:RODRIGUEZ, RUTH NOEMI (MSW)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:NOEMI
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND LOMA ALTA VLG # 13
Mailing Address - Street 2:L-3
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-7080
Mailing Address - Country:US
Mailing Address - Phone:787-365-5024
Mailing Address - Fax:
Practice Address - Street 1:COSTA DE ORO DORADO OFFICE SUITE
Practice Address - Street 2:SUITE 105
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-0588
Practice Address - Country:US
Practice Address - Phone:787-796-1100
Practice Address - Fax:787-796-1100
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR99461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical