Provider Demographics
NPI:1487790010
Name:RODRIGUEZ, LILLIAM (MED)
Entity type:Individual
Prefix:MRS
First Name:LILLIAM
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BROOKSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01129-2001
Mailing Address - Country:US
Mailing Address - Phone:413-846-4300
Mailing Address - Fax:413-732-0429
Practice Address - Street 1:120 MAPLE ST
Practice Address - Street 2:SUITE 402
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-2203
Practice Address - Country:US
Practice Address - Phone:413-846-4300
Practice Address - Fax:413-737-2437
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health