Provider Demographics
NPI:1215045703
Name:RODGERS, BRIGITTE ELISABETH (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:ELISABETH
Last Name:RODGERS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 ROLLING HILLS LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-6227
Mailing Address - Country:US
Mailing Address - Phone:925-855-5506
Mailing Address - Fax:925-855-9208
Practice Address - Street 1:4713 1ST ST
Practice Address - Street 2:242
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7361
Practice Address - Country:US
Practice Address - Phone:925-846-4829
Practice Address - Fax:925-855-9208
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4639235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist