Individual
MR. GUILLERMO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
1747 CITADEL PLZ STE 205, SAN ANTONIO, TX 78209-1017
(210) 788-2762
Mailing address
1747 CITADEL PLZ STE 205, SAN ANTONIO, TX 78209-1017
(210) 788-2762
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11022
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097782
AHCCCS
AZ
01
—
11758628
CAQH
TX
01
—
7739933
AETNA
AZ
Enumeration date
09/20/2006
Last updated
03/17/2018
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