Provider Demographics
NPI:1992260434
Name:BELARDO-RODRIGUEZ, SANDRA MARIA
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARIA
Last Name:BELARDO-RODRIGUEZ
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 1:3344 GROUSE HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-2351
Mailing Address - Country:US
Mailing Address - Phone:702-468-1570
Mailing Address - Fax:
Practice Address - Street 1:3344 GROUSE HOUSE LN
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-2351
Practice Address - Country:US
Practice Address - Phone:702-468-1570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling