Provider Demographics
NPI:1801256979
Name:GONZALEZ RODRIGUEZ, ALEJANDRA A (LMFT)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:A
Last Name:GONZALEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 LANGDON ST APT 702
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-1115
Mailing Address - Country:US
Mailing Address - Phone:773-242-0116
Mailing Address - Fax:
Practice Address - Street 1:626 LANGDON ST APT 702
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-1115
Practice Address - Country:US
Practice Address - Phone:773-242-0116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166000908106H00000X
WI1216106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist