Healthcare Provider Details

I. General information

NPI: 1699614552
Provider Name (Legal Business Name): MARIANA ISABEL RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 GOODWIN ST
SPRINGFIELD MA
01151-1983
US

IV. Provider business mailing address

399 GOODWIN ST
SPRINGFIELD MA
01151-1983
US

V. Phone/Fax

Practice location:
  • Phone: 413-306-0218
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: