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NPI Code Detail

MEDICARE: ALYSEN ROSCIA M.S.,CCC-SLP/L

MEDICARE: ALYSEN ROSCIA M.S.,CCC-SLP/L
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 PathologistSL011494PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114046790OTHERASHA
2SL011494OTHERPALICENSE

General Provider Information

NPI Number : 1649662727
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSEN ROSCIA M.S.,CCC-SLP/L
Provider Business Mailing Address
First Line : 314 MORNINGSIDE AVE
Second Line :
City : ALTOONA
State : PA
Zip : 16602-3032
Country : US
Telephone Number : 814-931-7685
Fax Number :
Provider Business Practice Location Address
First Line : 951 WASHINGTON AVE
Second Line :
City : TYRONE
State : PA
Zip : 16686-1426
Country : US
Telephone Number : 814-684-0320
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2015
Last Update Date : 02/25/2015

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