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NPI Code Detail

MEDICARE: BETTINA KARIN KELL RODRIGUEZ M.ED, LPC

MEDICARE: BETTINA KARIN KELL RODRIGUEZ M.ED, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor71290TX

General Provider Information

NPI Number : 1467090464
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETTINA KARIN KELL RODRIGUEZ M.ED, LPC
Provider Business Mailing Address
First Line : 5424 RUFE SNOW DR STE 304
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-6686
Country : US
Telephone Number : 817-576-2447
Fax Number : 844-273-0993
Provider Business Practice Location Address
First Line : 5424 RUFE SNOW DR STE 304
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-6686
Country : US
Telephone Number : 817-576-2447
Fax Number : 844-273-0993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2019
Last Update Date : 12/20/2019

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