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General NPI Number Information
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NPI Number | 1801509187
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Entity Type | Individual
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Provider Name | MISS TANIA LETICIA PEREZ RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 2921 11TH ST S
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City | ARLINGTON
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State | VA
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Zip | 22204-0827
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Country | US
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Telephone | 703-979-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 N VERMONT ST APT 203
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City | ARLINGTON
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State | VA
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Zip | 22201-4764
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Country | US
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Telephone | 208-881-3802
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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 |
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License Number State |
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