Provider Demographics
NPI:1104104694
Name:RODRIGUEZ, DARIEN GIZELA (SLP)
Entity type:Individual
Prefix:MRS
First Name:DARIEN
Middle Name:GIZELA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2553 CALLE PLAZUELA
Mailing Address - Street 2:CONSTTANCIA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-2228
Mailing Address - Country:US
Mailing Address - Phone:787-396-6310
Mailing Address - Fax:
Practice Address - Street 1:URB. CONSTANCIA
Practice Address - Street 2:2553 PLAZUELA ST.
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2228
Practice Address - Country:US
Practice Address - Phone:787-396-6310
Practice Address - Fax:787-284-6335
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR993235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist