Most Relevant Information
Provider Data
| NPI Number: | 1003288168 |
| Provider Name: | JACQUELINE RODRIGUEZ LADC,CAC,APP |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 001104 |
Most Important Dates
| Enumeration Date: | 10/28/2015 |
| Last Updated: | 10/31/2016 |
Provider Practice Location
243 SUCCESS AVE
BRIDGEPORT
CT
066102429
Practice Location Phone/Fax
| Phone: | 2038648429 |
| Fax: |
Provider Mailing Location
243 SUCCESS AVE
BRIDGEPORT
CT
066102429
Provider Mailing Phone/Fax
| Phone: | 2038648429 |
| Fax: |