Provider Demographics
NPI:1891917258
Name:RODRIGUEZ, GIANNA C
Entity Type:Individual
Prefix:
First Name:GIANNA
Middle Name:C
Last Name:RODRIGUEZ
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:P.O. BOX 143775
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-3775
Mailing Address - Country:US
Mailing Address - Phone:787-309-9397
Mailing Address - Fax:
Practice Address - Street 1:ALTURAS DE SAN FELIPE
Practice Address - Street 2:# 7 BO. CARRIZALES
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00614-3775
Practice Address - Country:US
Practice Address - Phone:787-309-9397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist