Provider Demographics
NPI:1326360561
Name:RODRIGUEZ, VERONICA NORMA
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:NORMA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S DON ROSER
Mailing Address - Street 2:STE D
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011
Mailing Address - Country:US
Mailing Address - Phone:575-522-5144
Mailing Address - Fax:575-522-5177
Practice Address - Street 1:1401 S DON ROSER
Practice Address - Street 2:STE D
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011
Practice Address - Country:US
Practice Address - Phone:575-522-5144
Practice Address - Fax:575-522-5177
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator