| Immanuel Rodriguez, | |
|
3742 W 4000 S, West Haven, UT 84401-9630 | |
| (801) 731-0426 | |
| Not Available |
| Full Name | Immanuel Rodriguez |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 3742 W 4000 S, West Haven, Utah |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134542798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Immanuel Rodriguez, 391 W 4800 S, Apt. 805, Washington Terrace, UT 84405-6062 Ph: (951) 529-6768 | Immanuel Rodriguez, 3742 W 4000 S, West Haven, UT 84401-9630 Ph: (801) 731-0426 |
Donicia G Martinez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3971 S 4000 W, West Haven, UT 84401 Phone: 801-814-7378 | |
Mrs. Kristi Daniels, ACMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3748 S 3600 W, West Haven, UT 84401 Phone: 801-644-4225 |