Provider Demographics
NPI:1003531161
Name:RODRIGUEZ, ZOE KAMBRIA (LMSW)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:KAMBRIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:PORTALES
Mailing Address - State:NM
Mailing Address - Zip Code:88130-0847
Mailing Address - Country:US
Mailing Address - Phone:575-214-1590
Mailing Address - Fax:575-562-4460
Practice Address - Street 1:1500 S AVENUE K, STATION 9
Practice Address - Street 2:
Practice Address - City:PORTALES
Practice Address - State:NM
Practice Address - Zip Code:88130-7400
Practice Address - Country:US
Practice Address - Phone:575-562-4455
Practice Address - Fax:575-562-4460
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2024-0717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health