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Individual

KELLY RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
1405 E GUADALUPE RD, TEMPE, AZ 85283-3971
(480) 921-3314
Mailing address
1405 E. GUADALUPE RD., 2111 E. BASELINE RD. STE. A-2, TEMPE, AZ 85283

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4889
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4889
ARIZONA BOARD OF PSYCHOLOGIST EXAMINERS
AZ
Enumeration date
05/08/2017
Last updated
03/11/2019
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