Provider Demographics
NPI:1295966737
Name:RODRIGUEZ, ISABEL CRISTINA (MA)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:CRISTINA
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:COND. SIERRA DEL SOL
Mailing Address - Street 2:APT. C-48
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0000
Mailing Address - Country:US
Mailing Address - Phone:787-717-3932
Mailing Address - Fax:
Practice Address - Street 1:STREET CONDADO 607
Practice Address - Street 2:SUITE 401
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-717-3932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3034103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst