Provider Demographics
NPI:1366880072
Name:RODRIGUEZ, BRIGIDA ANA (LPCMH)
Entity type:Individual
Prefix:MRS
First Name:BRIGIDA
Middle Name:ANA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 CASTLE RUN DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1416
Mailing Address - Country:US
Mailing Address - Phone:302-898-5184
Mailing Address - Fax:302-832-1919
Practice Address - Street 1:52 CASTLE RUN DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-1416
Practice Address - Country:US
Practice Address - Phone:302-898-5184
Practice Address - Fax:302-832-1919
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000639101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health