Organization
THERASPEECH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA DAWN RODRIGUEZ MA CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(765) 465-8314
Entity
Organization
Contact information
Practice address
9314 N PRAIRIE RD, SPRINGPORT, IN 47386-9502
(765) 465-8314
Mailing address
9314 N PRAIRIE RD, SPRINGPORT, IN 47386-9502
(765) 465-8314
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004787A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201298110
—
IN
Enumeration date
01/09/2018
Last updated
01/09/2018
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