Lacey-Lee Hokulani Rodriguez | Las Vegas, NV • PECOS Search

Lacey-Lee Hokulani Rodriguez

Counselor

Behavioral Health & Social Service Providers

6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067

PECOS Enrollment

Based on the most recent information from CMS, provider Lacey-Lee Hokulani Rodriguez does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1356714315
Provider Type
Individual
Full Name
Rodriguez, Lacey-Lee Hokulani
Gender
Female

Sole Proprietor
Yes
Enumeration Date
11/12/2015
Last Updated
11/12/2015

Contact Information

Practice Location

6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067

(702) 809-3507

Mailing Location

6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067

(702) 809-3507

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer