Provider Demographics
NPI:1447556592
Name:RODRIGUEZ, MELISSA G (OTR, MPH)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:G
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:OTR, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 N 23RD ST
Mailing Address - Street 2:STE A
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4166
Mailing Address - Country:US
Mailing Address - Phone:956-627-0108
Mailing Address - Fax:956-627-0110
Practice Address - Street 1:4325 N 23RD ST
Practice Address - Street 2:STE A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4166
Practice Address - Country:US
Practice Address - Phone:956-627-0108
Practice Address - Fax:956-627-0110
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105012225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist