Individual
ROBERTO RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1604 INDUSTRY DR STE 105, BASTROP, TX 78602-4622
(737) 251-2707
Mailing address
173 CASSEL WAY, BASTROP, TX 78602-5727
(651) 402-9564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302348
MN
106H00000X
Marriage & Family Therapist
Primary
204734
TX
106H00000X
Marriage & Family Therapist
3074
MN
Other
Enumeration date
12/31/2015
Last updated
12/27/2022
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