Provider Demographics
NPI:1467929893
Name:RODRIGUEZ, CORINA ASHLEY (ATC, LAT)
Entity Type:Individual
Prefix:MISS
First Name:CORINA
Middle Name:ASHLEY
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5502 SARATOGA BLVD APT 91
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2957
Mailing Address - Country:US
Mailing Address - Phone:512-350-9481
Mailing Address - Fax:
Practice Address - Street 1:1818 TROJAN DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78416-1319
Practice Address - Country:US
Practice Address - Phone:361-878-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT66622255A2300X
TX20000257452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer