Provider Demographics
NPI:1831245471
Name:RODRIGUEZ, DIGNA DAMARIS (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DIGNA
Middle Name:DAMARIS
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8744 108TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2229
Mailing Address - Country:US
Mailing Address - Phone:718-441-0036
Mailing Address - Fax:
Practice Address - Street 1:9527 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2224
Practice Address - Country:US
Practice Address - Phone:718-846-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0579861041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool