Provider Demographics
NPI:1467695312
Name:RODRIGUEZ, KAREN L (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:RODRIGUEZ
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 1:3022 COVENTRY CT
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-5843
Mailing Address - Country:US
Mailing Address - Phone:321-576-6961
Mailing Address - Fax:
Practice Address - Street 1:3022 COVENTRY CT
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32926-5843
Practice Address - Country:US
Practice Address - Phone:321-576-6961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist