Provider Demographics
NPI:1750781456
Name:RODRIGUEZ, KRIZIA (MA)
Entity type:Individual
Prefix:
First Name:KRIZIA
Middle Name:
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:EL ROSARIO II CALLE C K-7
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-515-4940
Mailing Address - Fax:
Practice Address - Street 1:K7 CALLE C
Practice Address - Street 2:EL ROSARIO 2
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-5720
Practice Address - Country:US
Practice Address - Phone:787-515-4940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3659103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist