Individual
MARIO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
344 E 100 S STE 301, SALT LAKE, UT 84111
(801) 428-4257
Mailing address
344 E 100 S STE 301, SALT LAKE, UT 84111
(801) 428-4257
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/04/2017
Last updated
07/21/2022
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