Provider Demographics
NPI:1942502240
Name:RODRIGUEZ, PATRICIA LAURA (PSY D)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LAURA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:LAURA
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6063 ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2721
Mailing Address - Country:US
Mailing Address - Phone:703-533-3930
Mailing Address - Fax:718-630-3372
Practice Address - Street 1:6063 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2721
Practice Address - Country:US
Practice Address - Phone:703-533-3930
Practice Address - Fax:718-630-3372
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019100103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)