Provider Demographics
NPI:1316503329
Name:VERA-RODRIGUEZ, ARIANNA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ARIANNA
Middle Name:
Last Name:VERA-RODRIGUEZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 WATERLOO DR
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6026
Mailing Address - Country:US
Mailing Address - Phone:512-586-5375
Mailing Address - Fax:
Practice Address - Street 1:267 WATERLOO DR
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6026
Practice Address - Country:US
Practice Address - Phone:512-586-5375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113805235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty