Individual
MICHAEL ROBERT RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3900 JUAN TABO BLVD NE, SUITE 12, ALBUQUERQUE, NM 87111-3984
(505) 275-6405
Mailing address
3900 JUAN TABO BLVD NE, SUITE 12, ALBUQUERQUE, NM 87111-3984
(505) 275-6405
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
268
NM
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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