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NPI 1013781632

NPI 1013781632 : DONJHA RENEE RODRIGUEZ-MADDOX LPC-A : ATASCOCITA, TX

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General NPI Number Information
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    NPI Number           |    1013781632
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    Entity Type          |    Individual 
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    Provider Name        |    DONJHA RENEE RODRIGUEZ-MADDOX LPC-A
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/14/2023
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    Last Update Date     |    11/14/2023
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Provider Practice Location Address
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    Address Line         |    18918 TIMBERS DR 
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    City                 |    ATASCOCITA
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    State                |    TX
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    Zip                  |    77346-2686
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    Country              |    US
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    Telephone            |    713-269-2631
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    18918 TIMBERS DR 
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    City                 |    ATASCOCITA
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    State                |    TX
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    Zip                  |    77346-2686
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    Country              |    US
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    Telephone            |    713-269-2631
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    86732
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    License Number State |    TX
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