Provider Demographics
NPI:1215270988
Name:RODRIGUEZ, KAREN J (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:J
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 STONE TRAIL ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-3533
Mailing Address - Country:US
Mailing Address - Phone:310-486-5994
Mailing Address - Fax:
Practice Address - Street 1:110 E TYLER ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-7224
Practice Address - Country:US
Practice Address - Phone:903-600-6797
Practice Address - Fax:903-600-6801
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10820225X00000X
TX123249225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist