Provider Demographics
NPI:1386979409
Name:RODRIGUEZ, MARLEN I (MT-BC, NMT)
Entity type:Individual
Prefix:
First Name:MARLEN
Middle Name:I
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HARVARD PL # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6242
Mailing Address - Country:US
Mailing Address - Phone:617-549-2960
Mailing Address - Fax:
Practice Address - Street 1:354 MERRIMACK ST
Practice Address - Street 2:2ND FLOOR SUITE 270
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1754
Practice Address - Country:US
Practice Address - Phone:978-291-0256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist