Provider Demographics
NPI:1992460554
Name:RODRIGUEZ, TANYA (LCDC)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:
Other - Last Name:MORALEZ RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCDC
Mailing Address - Street 1:1901 S 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6533
Mailing Address - Country:US
Mailing Address - Phone:956-289-7000
Mailing Address - Fax:956-289-7257
Practice Address - Street 1:2215 W BUSINESS 83
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-1100
Practice Address - Country:US
Practice Address - Phone:956-520-8800
Practice Address - Fax:956-289-7257
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)