Provider Demographics
NPI:1821713454
Name:RODRIGUEZ, DIANA MARIA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIA
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 1:3027 RANCHER HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3257
Mailing Address - Country:US
Mailing Address - Phone:346-217-8328
Mailing Address - Fax:
Practice Address - Street 1:5751 BLYTHEWOOD ST STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-5403
Practice Address - Country:US
Practice Address - Phone:346-217-8328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician