Provider Demographics
NPI:1093965659
Name:RODRIGUEZ, MARTA M (PSYD)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:M
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HALL DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002
Mailing Address - Country:US
Mailing Address - Phone:413-256-8561
Mailing Address - Fax:866-644-0869
Practice Address - Street 1:31 HALL DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2754
Practice Address - Country:US
Practice Address - Phone:413-256-8561
Practice Address - Fax:866-644-0869
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10300103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical