Provider Demographics
NPI:1922508969
Name:RODRIGUEZ, MARIANNE VICTORIA (SLP-A)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:VICTORIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:MS
Other - First Name:MARIANNE
Other - Middle Name:VICTORIA
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP-A
Mailing Address - Street 1:21630 MERCHANTS WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449
Mailing Address - Country:US
Mailing Address - Phone:832-230-1518
Mailing Address - Fax:281-741-7355
Practice Address - Street 1:21630 MERCHANTS WAY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449
Practice Address - Country:US
Practice Address - Phone:832-230-1518
Practice Address - Fax:281-741-7355
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38942235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist