Provider Demographics
NPI:1346476819
Name:FRITZ-RODRIGUEZ, MARIA TERESA (MA CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:TERESA
Last Name:FRITZ-RODRIGUEZ
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:TERSESA
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MACCC/SLP
Mailing Address - Street 1:417 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7818
Mailing Address - Country:US
Mailing Address - Phone:516-884-2816
Mailing Address - Fax:516-538-2357
Practice Address - Street 1:417 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:SOUTH HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-7818
Practice Address - Country:US
Practice Address - Phone:516-884-2816
Practice Address - Fax:516-538-2357
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013961235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist