Provider Demographics
NPI:1952013781
Name:RODRIGUEZ, SANTTIA M (PSR)
Entity Type:Individual
Prefix:
First Name:SANTTIA
Middle Name:M
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 REEF WAY APT 208
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-3139
Mailing Address - Country:US
Mailing Address - Phone:407-973-1577
Mailing Address - Fax:
Practice Address - Street 1:306 S 10TH ST # 340
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-5602
Practice Address - Country:US
Practice Address - Phone:863-438-7640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty