Individual
RICARDO ISRAEL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
151 S UNIVERSITY AVE, PROVO, UT 84601-4427
(801) 851-7127
Mailing address
1198 S 1220 W, PROVO, UT 84601-5470
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
12366411-3502
UT
Other
Enumeration date
12/28/2017
Last updated
12/15/2025
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