Provider Demographics
NPI:1669731311
Name:RODRIGUEZ, CONNI BETH (AUD)
Entity type:Individual
Prefix:MISS
First Name:CONNI
Middle Name:BETH
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 SW LANE ST
Mailing Address - Street 2:SUITE #200
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1543
Mailing Address - Country:US
Mailing Address - Phone:785-233-0500
Mailing Address - Fax:785-233-0660
Practice Address - Street 1:920 SW LANE ST
Practice Address - Street 2:SUITE #200
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2549
Practice Address - Country:US
Practice Address - Phone:785-233-0500
Practice Address - Fax:785-233-0660
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2043237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter