Provider Demographics
NPI:1881433639
Name:RODRIGUEZ, EMERY ANGEL (MS)
Entity type:Individual
Prefix:
First Name:EMERY
Middle Name:ANGEL
Last Name:RODRIGUEZ
Suffix:
Gender:X
Credentials:MS
Other - Prefix:
Other - First Name:ELISA
Other - Middle Name:ANGELICA
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:9901 BRODIE LANE
Mailing Address - Street 2:SUITE 160 PMB611
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2204 FAIR OAKS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-2752
Practice Address - Country:US
Practice Address - Phone:817-729-2567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health