Provider Demographics
NPI:1225347370
Name:ROSSINI, TABITHA KRISTY (AUD)
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:KRISTY
Last Name:ROSSINI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6736 TIMBER RUN LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-8601
Mailing Address - Country:US
Mailing Address - Phone:865-888-4327
Mailing Address - Fax:658-888-4327
Practice Address - Street 1:2190 WINFIELD DUNN PKWY STE 6
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37876-0502
Practice Address - Country:US
Practice Address - Phone:865-888-4327
Practice Address - Fax:865-888-4327
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-06
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1549231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3730962Medicaid
TN3730962Medicaid