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NPI Code Detail

MEDICARE: TIFFANY TRASK

MEDICARE: TIFFANY TRASK
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
1235Z00000XSpeech-Language Pathologist14037899SD
2235Z00000XSpeech-Language Pathologist429-SLPSD

General Provider Information

NPI Number : 1710331921
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY TRASK
Provider Business Mailing Address
First Line : 13455 ROCKWOOD RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-6502
Country : US
Telephone Number : 605-209-8792
Fax Number :
Provider Business Practice Location Address
First Line : 4447 S CANYON RD STE 6
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-1889
Country : US
Telephone Number : 605-443-6164
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2016
Last Update Date : 07/11/2022

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Directions to “ TIFFANY TRASK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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