Healthcare Provider Details

I. General information

NPI: 1881788313
Provider Name (Legal Business Name): MALLORI JO ROSSING M.A. CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 WIND RIVER RUN
CLERMONT FL
34711-8970
US

IV. Provider business mailing address

3570 WIND RIVER RUN
CLERMONT FL
34711-8970
US

V. Phone/Fax

Practice location:
  • Phone: 407-625-9031
  • Fax: 321-300-0223
Mailing address:
  • Phone: 407-625-9031
  • Fax: 321-300-0223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA6942
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: