Individual
MARY V RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
810 N 6TH AVE, PHOENIX, AZ 85003-1318
(602) 462-1115
(602) 462-1119
Mailing address
5605 N 11TH AVE, PHOENIX, AZ 85013-1761
(602) 401-1765
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW21370
AZ
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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