Provider Demographics
NPI:1063537447
Name:RODRIQUEZ, JENNIFER BRIER (BS, CSAC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BRIER
Last Name:RODRIQUEZ
Suffix:
Gender:F
Credentials:BS, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 N BELVEDERE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-2426
Mailing Address - Country:US
Mailing Address - Phone:910-270-5329
Mailing Address - Fax:
Practice Address - Street 1:1606 PHYSICIANS DR
Practice Address - Street 2:SUITE 104
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7361
Practice Address - Country:US
Practice Address - Phone:910-362-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1973101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)