Provider Demographics
NPI:1174369060
Name:RODRIGUEZ, ALYSSA REANNE
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:REANNE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 ARANSAS PASS DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-8494
Mailing Address - Country:US
Mailing Address - Phone:956-844-3555
Mailing Address - Fax:
Practice Address - Street 1:1607 ARANSAS PASS DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-8494
Practice Address - Country:US
Practice Address - Phone:956-844-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant