Provider Demographics
NPI:1740942937
Name:RODRIGUEZ, RUMMY (CSWA)
Entity type:Individual
Prefix:
First Name:RUMMY
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2958 TUMBLEWOOD GRV
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-4470
Mailing Address - Country:US
Mailing Address - Phone:458-802-3883
Mailing Address - Fax:
Practice Address - Street 1:1299 NW ELLAN STREET UITE 2
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-8091
Practice Address - Country:US
Practice Address - Phone:949-514-3658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical