Provider Demographics
NPI:1063283299
Name:RODRIGUEZ-ASI, AGUSTA
Entity type:Individual
Prefix:
First Name:AGUSTA
Middle Name:
Last Name:RODRIGUEZ-ASI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10816 MONTEREY BAY CT NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-1997
Mailing Address - Country:US
Mailing Address - Phone:505-288-1750
Mailing Address - Fax:
Practice Address - Street 1:1207 GOLF COURSE RD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1999
Practice Address - Country:US
Practice Address - Phone:505-994-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty