Individual
DR. CARLOS JOSE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1301 W 17TH STREET, PUEBLO, CO 81003-1915
(719) 545-5211
(719) 545-1962
Mailing address
PO BOX 3336, PUEBLO, CO 81005-0336
(719) 545-5211
(719) 545-1962
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1004
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007928
—
CO
05
—
07109952
—
CO
Enumeration date
08/17/2006
Last updated
02/28/2008
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