Provider Demographics
NPI:1518005255
Name:RODRIGUEZ-HERMAN, LINDA IRIS (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:IRIS
Last Name:RODRIGUEZ-HERMAN
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3499 BUNKER AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3436
Mailing Address - Country:US
Mailing Address - Phone:516-826-8137
Mailing Address - Fax:516-826-8137
Practice Address - Street 1:3499 BUNKER AVE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3436
Practice Address - Country:US
Practice Address - Phone:516-826-8137
Practice Address - Fax:516-826-8137
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004987-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist