Individual
MR. GUSTAVO ALBERT RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISAC
Contact information
Practice address
3802 W 16TH ST, YUMA, AZ 85364-4107
(928) 376-0026
(928) 782-2298
Mailing address
3802 W 16TH ST, YUMA, AZ 85364-4107
(928) 376-0026
(928) 782-2298
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-1257
AZ
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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