Provider Demographics
NPI:1497032775
Name:RODRIGUES GARCIA, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RODRIGUES GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SDEROT MENACHEM BEGIN
Mailing Address - Street 2:APARTMENT 3
Mailing Address - City:MODIIN MACCABIM REUT
Mailing Address - State:ISRAEL
Mailing Address - Zip Code:7172331
Mailing Address - Country:IL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:102 SDEORT MENACHEM BEGIN
Practice Address - Street 2:APARTMENT 3
Practice Address - City:MODIIN
Practice Address - State:ISRAEL
Practice Address - Zip Code:7172331
Practice Address - Country:IL
Practice Address - Phone:914-292-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019342235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist