Provider Demographics
NPI:1740602267
Name:RODRIGUEZ, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
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 1:250 COMMERCIAL ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1726
Mailing Address - Country:US
Mailing Address - Phone:508-752-4665
Mailing Address - Fax:508-752-0947
Practice Address - Street 1:250 COMMERCIAL ST
Practice Address - Street 2:SUITE 330
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1726
Practice Address - Country:US
Practice Address - Phone:508-752-4665
Practice Address - Fax:508-752-0947
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health