Provider Demographics
NPI:1528498656
Name:RODRIGUEZ ROSADO, JESSICA (MSW)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:RODRIGUEZ ROSADO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 22032
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-8514
Mailing Address - Country:US
Mailing Address - Phone:787-376-6340
Mailing Address - Fax:
Practice Address - Street 1:VILLA LOS SANTOS
Practice Address - Street 2:M1 CALLE 9 SUITE 1
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-376-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR117591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical