Provider Demographics
NPI:1649493859
Name:RODRIGUEZ, MELISSA KAY (BC-HIS, PHD)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:KAY
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BC-HIS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 PIEDMONT DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1725
Mailing Address - Country:US
Mailing Address - Phone:915-494-5485
Mailing Address - Fax:
Practice Address - Street 1:201 BLACKER AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3324
Practice Address - Country:US
Practice Address - Phone:915-532-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50495237700000X
NM507237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist