Provider Demographics
NPI:1255705570
Name:RODRIGUE, MARION PLESSNER (MS, LMHC)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:PLESSNER
Last Name:RODRIGUE
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S ORLANDO AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5644
Mailing Address - Country:US
Mailing Address - Phone:407-378-3001
Mailing Address - Fax:
Practice Address - Street 1:400 S ORLANDO AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5644
Practice Address - Country:US
Practice Address - Phone:407-378-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13841101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health