| Doctor Name: | JEANNETTE RODRIGUEZ |
| NPI Number: | 1174958599 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 783963 |
| Business Practice Address: | 7252 Metropolitan Ave Middle Village, NY - 113792100 |
| Business Phone Number: | 7183260055 |
| Business Fax Number: | |
| Mailing Address: | 8405 112th St, RICHMOND HILL |
| State: | NY |
| Postal Code: | 114181335 |
| Phone Number: | 6462085708 |
| Fax Number: | |
| NPI Enumeration Date: | 09/04/2013 |
| NPI Last Update Date: | 09/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | 783963 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |