MEDICARE: MRS. ALICIA M ROSSOW M.A., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	15983	TX

General Provider Information

NPI Number	:	1588857221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA M ROSSOW M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	1728 FORT GRANT DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-7818
Country	:	US
Telephone Number	:	512-636-1649
Fax Number	:	512-388-7962

Provider Business Practice Location Address
First Line	:	1728 FORT GRANT DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-7818
Country	:	US
Telephone Number	:	512-636-1649
Fax Number	:	512-388-7962

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	08/27/2007

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Directions to “ MRS. ALICIA M ROSSOW M.A., CCC-SLP” Practice Location

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