Provider Demographics
NPI:1184051427
Name:ROSEN, TZIVIA ESTI (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:TZIVIA
Middle Name:ESTI
Last Name:ROSEN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11306 MONTICELLO AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3079
Mailing Address - Country:US
Mailing Address - Phone:433-887-6024
Mailing Address - Fax:
Practice Address - Street 1:32 CONSHOHOCKEN STATE RD
Practice Address - Street 2:APT G1
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3336
Practice Address - Country:US
Practice Address - Phone:610-664-2608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08184235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist