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NPI 1962519629

NPI 1962519629 : ADA G. RODRIGUEZ MA, LPC : NEWINGTON, CT

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General NPI Number Information
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    NPI Number           |    1962519629
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    Entity Type          |    Individual 
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    Provider Name        |    ADA G. RODRIGUEZ MA, LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/25/2006
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    Last Update Date     |    08/24/2023
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Provider Practice Location Address
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    Address Line         |    100 MARKET SQ STE 14 
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    City                 |    NEWINGTON
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    State                |    CT
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    Zip                  |    06111-2921
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    Country              |    US
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    Telephone            |    860-665-9733
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    Fax                  |    860-541-5352
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Provider Business Mailing Address
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    Address Line         |    100 MARKET SQ STE 14 
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    City                 |    NEWINGTON
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    State                |    CT
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    Zip                  |    06111-2921
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    Country              |    US
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    Telephone            |    860-665-9733
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    Fax                  |    860-541-5352
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    000443
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    License Number State |    CT
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