Individual
DR. GABRIELA MARIE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1002 WISHARD BLVD STE 4110, INDIANAPOLIS, IN 46202-2872
(317) 944-8162
(317) 948-0609
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(317) 963-4561
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043126A
IN
103TC2200X
Clinical Child & Adolescent Psychologist
20043126A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264430817
MEDICARE PTAN
IN
05
—
300020689
—
IN
Enumeration date
12/30/2016
Last updated
12/30/2020
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