Provider Demographics
NPI:1295243103
Name:RODRIGUEZ, ZAIRA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ZAIRA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 FARNHAM PT APT 203
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-5218
Mailing Address - Country:US
Mailing Address - Phone:956-525-1746
Mailing Address - Fax:
Practice Address - Street 1:3090 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5310
Practice Address - Country:US
Practice Address - Phone:719-574-8300
Practice Address - Fax:719-574-9547
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist