Healthcare Provider Details

I. General information

NPI: 1457096216
Provider Name (Legal Business Name): FRANCES MARIE RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 FABER PLACE DR STE 420
NORTH CHARLESTON SC
29405-8594
US

IV. Provider business mailing address

4105 FABER PLACE DR STE 420
NORTH CHARLESTON SC
29405-8594
US

V. Phone/Fax

Practice location:
  • Phone: 321-662-8445
  • Fax:
Mailing address:
  • Phone: 321-662-8445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8590
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30001550
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: