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General NPI Number Information
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NPI Number | 1275442204
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Entity Type | Individual
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Provider Name | KELLYANNE RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 3300 HENRY AVE
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City | PHILA
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State | PA
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Zip | 19129-1141
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Country | US
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Telephone | 215-254-2026
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Fax |
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Provider Business Mailing Address
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Address Line | 111 ELWYN RD
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City | MEDIA
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State | PA
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Zip | 19063-4622
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Country | US
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Telephone | 610-891-2000
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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