Individual
ELIZABETH RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
829 DOLORES DR NW, ALBUQUERQUE, NM 87105-1357
(505) 400-9259
Mailing address
PO BOX 27283, ALBUQUERQUE, NM 87125-7283
(505) 400-9259
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
FA0112269
NM
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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