Provider Demographics
NPI:1699503854
Name:RODRIGUEZ, ALYSSA MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 NEW TERRITORY BLVD APT 4105
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5976
Mailing Address - Country:US
Mailing Address - Phone:713-367-5042
Mailing Address - Fax:
Practice Address - Street 1:5555 NEW TERRITORY BLVD APT 4105
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5976
Practice Address - Country:US
Practice Address - Phone:713-367-5042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106216104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker