Provider Demographics
NPI:1609374289
Name:RODRIGUEZ, MERRIE MADELINE
Entity Type:Individual
Prefix:MRS
First Name:MERRIE
Middle Name:MADELINE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MERRIE
Other - Middle Name:MADELINE
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3318 BAMBERG WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6737
Mailing Address - Country:US
Mailing Address - Phone:281-980-5692
Mailing Address - Fax:
Practice Address - Street 1:3318 BAMBERG WAY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6737
Practice Address - Country:US
Practice Address - Phone:281-980-5692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX391202355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant