Individual
DENNELLE RENEE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(971) 409-3499
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(971) 409-3499
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015939
OR
235Z00000X
Speech-Language Pathologist
LL60632606
WA
235Z00000X
Speech-Language Pathologist
SI 60550989
WA
Other
Enumeration date
09/12/2015
Last updated
04/10/2017
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