Provider Demographics
NPI:1831505163
Name:RODRIGUEZ-GUZMAN, VON MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:VON MARIE
Middle Name:
Last Name:RODRIGUEZ-GUZMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 WARREN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-1432
Mailing Address - Country:US
Mailing Address - Phone:401-606-3711
Mailing Address - Fax:401-606-3712
Practice Address - Street 1:950 WARREN AVE STE 104
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1432
Practice Address - Country:US
Practice Address - Phone:401-606-3711
Practice Address - Fax:401-606-3712
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022199103TC0700X
RIPS01658103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical