Provider Demographics
NPI:1932481728
Name:RODRIGUEZ, HILDA E (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HILDA
Middle Name:E
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13339 127TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-3301
Mailing Address - Country:US
Mailing Address - Phone:718-843-3669
Mailing Address - Fax:718-843-3669
Practice Address - Street 1:13339 127TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-3301
Practice Address - Country:US
Practice Address - Phone:718-843-3669
Practice Address - Fax:718-843-3669
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008966-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist