Provider Demographics
NPI:1588810063
Name:RODRIGUEZ, ALBA JANNISSE (BS)
Entity type:Individual
Prefix:MISS
First Name:ALBA
Middle Name:JANNISSE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BS
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Mailing Address - Street 1:STREET CORCOVADO SAN DEMETRIO
Mailing Address - Street 2:# 829
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3519
Mailing Address - Country:US
Mailing Address - Phone:787-783-2226
Mailing Address - Fax:787-862-3735
Practice Address - Street 1:STREET CORCOVADO SAN DEMETRIO
Practice Address - Street 2:# 829
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3519
Practice Address - Country:US
Practice Address - Phone:787-783-2226
Practice Address - Fax:787-862-3735
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8192355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant