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Individual

MRS. LISA MARIE RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
7701 BAYBROOK RD NW, ALBUQUERQUE, NM 87120-6536
(505) 450-6862
Mailing address
7701 BAYBROOK RD NW, ALBUQUERQUE, NM 87120-6536
(505) 450-6862

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3886
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45629234
NM
Enumeration date
02/28/2007
Last updated
07/08/2007
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