Provider Demographics
NPI:1578393732
Name:RODRIGUEZ, REESE ELLE
Entity type:Individual
Prefix:
First Name:REESE
Middle Name:ELLE
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 1:305 ESPERANZA DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2611
Mailing Address - Country:US
Mailing Address - Phone:956-898-8781
Mailing Address - Fax:
Practice Address - Street 1:4600 LOCKHILL SELMA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2186
Practice Address - Country:US
Practice Address - Phone:888-861-4317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant