Provider Demographics
NPI:1700503398
Name:RODRIGUEZ, JANET (CCC-SLP, TSSLD-B/E)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CCC-SLP, TSSLD-B/E
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8055 CORNISH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3728
Mailing Address - Country:US
Mailing Address - Phone:718-446-2726
Mailing Address - Fax:
Practice Address - Street 1:8055 CORNISH AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3728
Practice Address - Country:US
Practice Address - Phone:718-446-2726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032486-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist