Provider Demographics
NPI:1548146137
Name:RODRIGUEZ, TIANA ALEXIS (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TIANA
Middle Name:ALEXIS
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 1:518 NATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2014
Mailing Address - Country:US
Mailing Address - Phone:516-425-3464
Mailing Address - Fax:
Practice Address - Street 1:350 BEACH 54TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11692-1790
Practice Address - Country:US
Practice Address - Phone:718-945-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034720-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist