| Doctor Name: | MRS. KELLIE LYNN RODRIGUEZ |
| NPI Number: | 1205274271 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP, M.S. |
| License Number: | 19728 |
| Business Practice Address: | 3630 N Josey Ln Suite 100 Carrollton, TX - 750073159 |
| Business Phone Number: | 4698927500 |
| Business Fax Number: | 8882377500 |
| Mailing Address: | 3620 N. Josey Lane, Suite 210 CARROLLTON |
| State: | TX |
| Postal Code: | 750073159 |
| Phone Number: | 4698927500 |
| Fax Number: | 8882372214 |
| NPI Enumeration Date: | 06/11/2013 |
| NPI Last Update Date: | 07/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 19728 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |