MEDICARE: TIANNA DEL ROSSO SLPA

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	2355S0801X	Speech-Language Assistant	205160	AK

General Provider Information

NPI Number	:	1871290361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIANNA DEL ROSSO SLPA

Provider Business Mailing Address
First Line	:	PO BOX 241889
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99524-1889
Country	:	US
Telephone Number	:	907-563-1777
Fax Number	:	907-561-7464

Provider Business Practice Location Address
First Line	:	1051 E BOGARD RD STE 1
Second Line	:
City	:	WASILLA
State	:	AK
Zip	:	99654-7174
Country	:	US
Telephone Number	:	628-777-3539
Fax Number	:	833-211-4855

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

Provider Enumeration Date	:	02/14/2023
Last Update Date	:	02/14/2023

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Directions to “ TIANNA DEL ROSSO SLPA” Practice Location

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