Provider Demographics
NPI:1023274594
Name:RODRIGUEZ, MARY BETH (MED)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BETH
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 N BEAR CANYON RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-8220
Mailing Address - Country:US
Mailing Address - Phone:520-584-4800
Mailing Address - Fax:520-584-4801
Practice Address - Street 1:3900 N BEAR CANYON RD.
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-8220
Practice Address - Country:US
Practice Address - Phone:520-584-4800
Practice Address - Fax:520-584-4801
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool