Individual
AMANDA MARIE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5104
(405) 835-1699
Mailing address
800 LEXINGTON ST TRLR 230, NORMAN, OK 73069-8918
(405) 835-1699
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245445337
—
OK
Enumeration date
02/13/2020
Last updated
11/27/2023
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