Provider Demographics
NPI:1811750516
Name:RODRIGUEZ RAMIREZ, WOLFGANG LEONARDO (LPC)
Entity type:Individual
Prefix:
First Name:WOLFGANG
Middle Name:LEONARDO
Last Name:RODRIGUEZ RAMIREZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:WOLFGANG
Other - Middle Name:LEONARDO
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:371 OAKDALE CIR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7348
Mailing Address - Country:US
Mailing Address - Phone:434-237-2655
Mailing Address - Fax:
Practice Address - Street 1:371 OAKDALE CIR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7348
Practice Address - Country:US
Practice Address - Phone:434-237-2655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional