Provider Demographics
NPI:1154533362
Name:RODRIGUES, DANIELA S
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:S
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:DOS SANTOS
Other - Last Name:RODRIGUES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:3324 HILLINGDON CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7328
Mailing Address - Country:US
Mailing Address - Phone:702-243-8636
Mailing Address - Fax:
Practice Address - Street 1:3324 HILLINGDON CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7328
Practice Address - Country:US
Practice Address - Phone:702-243-8636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP822235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500606Medicaid