Provider Demographics
NPI:1730436999
Name:RODRIGUEZ, MELISSA JEAN (PSYD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JEAN
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 1:4242 MEDICAL DR STE 7250
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5369
Mailing Address - Country:US
Mailing Address - Phone:210-504-6393
Mailing Address - Fax:210-941-0144
Practice Address - Street 1:4242 MEDICAL DR STE 7250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5369
Practice Address - Country:US
Practice Address - Phone:210-504-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38175103TC0700X, 103TC0700X
225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical